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

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OHE Consulting Report for PhRMA 5 January 2011 The degree of centralisation .................................................................................................................... 45 6.3.2 The focus of HTA: what is the appraisal concerned with? ........................................................... 45 7 HEALTH CARE SYSTEMS AND HTA IN BRAZIL, CHINA AND TAIWAN ................................................... 47 7.1 SOURCES OF INFORMATION ...................................................................................................................... 47 7.2 SUMMARY OF FINDINGS ON THE THREE COUNTRIES ........................................................................................ 52 7.2.1 Brazil ............................................................................................................................................ 52 7.2.2 China ........................................................................................................................................... 53 7.2.3 Taiwan ......................................................................................................................................... 55 8 WHAT ROLE DOES HTA HAVE IN EMERGING MARKETS? LESSONS FROM BRAZIL, TAIWAN, AND CHINA 56 8.1 THE THREE MARKETS IN THE CONTEXT OF THE MODEL .................................................................................. 56 8.2 OPTIONS FOR THE DEVELOPMENT OF HTA IN THE THREE MARKETS ................................................................... 62 8.3 AN INDUSTRY PERSPECTIVE ON HTA: IFPMA, PHRMA AND EFPIA PRINCIPLES ................................................. 64 8.4 ISSUES FOR PHRMA IN DEVELOPING PUBLIC POLICY POSITIONS ........................................................................ 67 APPENDIX I: OVERVIEW OF THE BRAZILIAN HEALTH CARE SYSTEM AND THE USE OF HEALTH TECHNOLOGY ASSESSMENT FOR THE EVALUATION OF PHARMACEUTICALS ........................................................................ 68 A1.1 OVERVIEW OF BRAZILIAN HEALTH CARE FINANCING AND DELIVERY SYSTEM ........................................ 69 A1.2 PUBLIC HEALTHCARE ............................................................................................................................. 71 A1.3 PRIVATE HEALTH CARE SYSTEM ............................................................................................................. 74 A1.4 HEALTH TECHNOLOGY ASSESSMENT IN BRAZIL ..................................................................................... 75 A1.5 INCORPORATION OF NEW DRUGS IN THE BRAZILIAN HEALTH CARE SYSTEM ........................................ 77 A1.6 KEY FINDINGS AND ISSUES ..................................................................................................................... 79 APPENDIX 2: OVERVIEW OF THE CHINESE HEALTH CARE SYSTEM AND THE USE OF HEALTH TECHNOLOGY ASSESSMENT FOR THE EVALUATION OF PHARMACEUTICALS ........................................................................ 83 A2.1 OVERVIEW OF THE CHINESE HEALTH CARE DELIVERY AND FINANCING SYSTEM .................................... 84 A2.2 EVOLUTION OF POPULATION COVERAGE .............................................................................................. 84 A.2.3 THE INITIATION OF HEALTH COVERAGE REFORM IN 2003..................................................................... 86 A2.4 REMAINING CHALLENGES AND OTHER ASPECTS OF REFORM ................................................................ 86 A2.5 DRUG PURCHASING ............................................................................................................................... 89 A2.6 THE ROLE OF HTA IN CHINA ................................................................................................................... 91 A2.7 KEY ISSUES ............................................................................................................................................. 92 APPENDIX 3: OVERVIEW OF THE TAIWANESE HEALTH CARE SYSTEM AND THE USE OF HEALTH TECHNOLOGY ASSESSMENT FOR THE EVALUATION OF PHARMACEUTICALS ........................................................................ 95 A3.1 OVERVIEW OF TAIWANESE HEALTH CARE FINANCING, INSURANCE, AND DELIVERY SYSTEM ................ 97 A3.2 POPULATION, COVERAGE, EXPENDITURE .............................................................................................. 97 A3.3 FINANCING ............................................................................................................................................ 97 A3.4 PHARMACEUTICAL COVERAGE .............................................................................................................. 98 A3.5 PHARMACEUTICAL DISTRIBUTION ......................................................................................................... 99 A3.6 INCORPORATION OF NEW DRUGS IN THE TAIWANESE HEALTH CARE SYSTEM ...................................... 99 A3.7 PRICING OF NEW DRUGS ..................................................................................................................... 100 A3.8 HEALTH TECHNOLOGY ASSESSMENT IN TAIWAN ................................................................................. 101 4
OHE Consulting Report for PhRMA 5 January 2011 A3.9 ROLE OF HTA........................................................................................................................................ 102 A3.10 FUTURE OF HTA IN TAIWAN: FINDINGS AND ISSUES ......................................................................... 103 A4.1 HTA AND YOUR HEALTHCARE SYSTEM ................................................................................................. 105 A4.2 DISSEMINATION OF INFORMATION ..................................................................................................... 105 A4.3 TOPIC SELECTION ................................................................................................................................. 105 A4.4 COVERAGE OF HTA IN CHINA/BRAZIL/TAIWAN ................................................................................... 105 A4.5 INFORMATION USE (ABILITY TO LEARN WITH/FROM OTHER COUNTRIES ALSO DEVELOPING OR HAVING DEVELOPED HTA AND USE OF INFORMATION FROM INTERNAL ORGANISATIONS) ...................................... 106 A4.6 CHALLENGES ........................................................................................................................................ 106 A4.7 STAKEHOLDERS AND THE POLICY DEBATE ........................................................................................... 106 A4.8 LITERATURE ......................................................................................................................................... 106 APPENDIX 5: INTERVIEW PROGRAMME ....................................................................................................... 107 APPENDIX 6: INTERVIEW SUMMARIES ......................................................................................................... 109 A6.1 BRAZIL ................................................................................................................................................. 109 INDUSTRY VIEW ........................................................................................................................................... 109 ACADEMIC VIEW .......................................................................................................................................... 109 PRIVATE SECTOR PAYER VIEW ..................................................................................................................... 110 A6.2 CHINA .................................................................................................................................................. 110 ACADEMIC PERSPECTIVE .............................................................................................................................. 110 INDUSTRY PERSPECTIVE ............................................................................................................................... 111 A6.3 TAIWAN ............................................................................................................................................... 111 INDUSTRY VIEW ........................................................................................................................................... 111 ACADEMIC VIEW .......................................................................................................................................... 112 GOVERNMENT VIEW .................................................................................................................................... 113 REFERENCES ................................................................................................................................................. 114 5
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The Evolution of HTA in Emerging Markets Health-Care ... - TREE

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