This is a guest post by Moriah Pollock-Hawthorne, Haverford University.
I was an intern at NICE International and an American university student with aspirations to become a doctor. In an effort to learn about universal health coverage and experience a single-payer healthcare system in action, I came to England; I shadowed doctors in NHS clinics, sat in on technology appraisal meetings where I discovered NICE’s role in ensuring affordability and standards of care for medicine in the NHS, and then had a brief internship in which I learned how NICE International applies the experience of NICE and the NHS to help other countries develop principles, priorities, and guidelines as these countries begin to create or expand their own healthcare systems. Continue reading
Every healthcare system in the world has to set priorities and make choices. Economic evaluation, in the context of health technology assessment, provides the decision makers with a framework for assessing the costs and benefits of various competing options, to inform fair and efficient use of limited healthcare resources. Prof Tony Culyer explains in this presentation: Why do we do economic evaluation?
Prof Culyer is the Chair of the iDSI Steering Group; Chair in Economics at University of York; Ontario Research Chair in Health Policy and System Design at University of Toronto; and founding Vice Chair of NICE.
In health systems, although there are many stakeholders with different interests (healthcare practitioners, policymakers, industry, patients and the public), many share the value of better health for all. However, when a decision needs to be made, it is not easy for them to agree or talk together constructively. Will there be any way to help them talk together constructively and to make the best use of the limited healthcare resources? See this short animation produced by HITAP.
Nattha Tritasavit and Chalarntorn Yothasamutra
One day I was perusing the news and came across an article about the inclusion of five new high-cost drugs in the Thai benefits package. Unbeknownst to me, the Thai Universal Health Coverage (UHC) released a news article in all domestic newspapers informing the public that the Director-General of the National Health Security Office (NHSO), which manages UHC, claimed that the decision to include the high-cost drugs by the NHSO board was made based on evidence supported by an HTA agency. This was regardless of the fact that there is no law in place mandating the use of evidence to inform policy in Thailand. We write about this event not to proclaim the success of an HTA agency in a low- and middle-income country, but to share our view regarding a possible indicator for measuring HTA impact.
Developing HTA systems in low- and middle income countries, one of the aims of the iDSI, is regarded as one of the most challenging tasks. Establishing HTA in any setting does not only include completing HTA reports and training local staff to conduct HTA, but it also means institutionalizing HTA and creating social capital from it. This case illustrates the impact of making HTA attractive enough for decision makers to use it willingly as a defense for their decisions to the public.
Note: the evidence generated for one of the high-cost drugs was conducted in collaboration with Silapakorn University and Ramathibodi Hospital.
See more research about HTA project at www.hitap.net
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By: Yot Teerawattananon and Nattha Tritasavit
Finding true north is important for accurate navigation to embarking on the right path. While there may be many paths to making policy decisions, the ultimate goal is to end up with a decision that has been well-informed by evidence. Evidenced-based policy decisions result in more transparent and effective outcomes that are defendable to the public. A case in point is the expansion of antiretroviral treatment (ART) for HIV/AIDS in Thailand. Continue reading
The 67th World Health Assembly, Geneva, May 2014
At the 67th World Health Assembly in Geneva in May 2014, a resolution was adopted on Health intervention and technology assessment in support of universal health coverage. Prof David Haslam, Chair of NICE, representing the UK Mission Geneva, addressed the Assembly during a panel session on the role of priority-setting in universal health coverage, alongside counterparts from Thailand, Iran, Ethiopia and the World Health Organisation. The resolution called on Member States to develop and strengthen national and regional capacities for priority-setting, and for the WHO to support these efforts. WHO Director General, Dr Margaret Chan, attended the session and made supportive remarks about the work of NICE, which was named as a “resource organisation” for health technology assessment. Continue reading
iDSI aims to help policymakers in low and middle income countries in building capacity for active priority-setting, such that they can spend limited health budgets in a more efficient and equitable way, and achieve sustainable universal health coverage (UHC). In order to help achieve iDSI this aim, we at NICE International have developed a questionnaire to assess countries’ ‘priority-setting readiness’. We believe this is the first published questionnaire that comprehensively captures priority-setting readiness at a health systems level, beyond the technical dimension of health technology assessment (HTA).
We are now making this questionnaire freely available as a global public good, and we hope it will be useful to policymakers, global health funders, academics and international development partners.
Download iDSI Priority-setting Questionnaire v1.0 – Jun 2014
Our questionnaire builds on an earlier questionnaire developed jointly with HITAP for the purposes of a training workshop in Hanoi, Vietnam (Situation analysis of HTA Introduction at national level, version 2.0, October 2013; for non-commercial use only).