The Evolution of HTA in Emerging Markets Health-Care ... - TREE

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OHE Consulting Report for PhRMA 5 January 2011 The article presents country HTA case studies under a number of headings that we considered as a potential useful and helpful guide in developing taxonomy of HTA systems. These headings are depicted in Table 1 below. To this list of headings we add from Hailey and Juzwishin (2006) another useful dimension for classification of HTA systems. This article’s objective was to identify issues (referred to as ‘risks’) that institutions that perform HTA should consider and how these risks could be managed. These risks and approaches to their management were compiled from opinions of members of the International Network of Agencies for Health Technology Assessment (INATHA). The authors identified 21 ‘risks’ categorized under the headings: formulation of HTA questions, preparation of the HTA product, dissemination and contracting. 34
OHE Consulting Report for PhRMA 5 January 2011 Table 1: A characterization of HTA systems HTA governance and organization • Institutions/committees • Entities responsible for reviewing HTA evidence for priority setting and decision-‐making • HTA agenda-‐setting body • Reimbursement requirements and limitations • Stakeholder involvement • International collaboration HTA topic selection and analytical design • Governance of topic selection • Criteria for topic selection • Criteria for assessment • Criteria outlined or publicly available • Analysis perspective • Duration required to conduct assessments Evidence requirements and assessment methods • Documents required from manufacturer • Systematic literature review and synthesis • Unpublished data/grey literature • Preferred clinical study type/evidence • Type of economic assessment preferred or required • Availability of guidelines outlining methodological requirements • Methodological requirements covering issues such as choice of comparator, specification of (preferred) outcome variable, subgroup analyses, type of costs (direct or indirect), incremental analysis required, time horizon, equity issues, discounting, modelling, sensitivity analyses, CE or WTP threshold, sensitivity analyses, missing or complete data and support for methodological development HTA dissemination and implementation • Channels for HTA dissemination • Use of HTA results • Evidence considered in decision-‐making • Any reported obstacles to effective implementation such as legal proceedings etc. • Formal processes to measure impact • Process for re-‐evaluation or appeals • Accountability for stakeholder input • Transparent/public decision-‐making process 35
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