Strengthening HTA agencies in Asia: Learning and sharing experiences for the APO Policy Brief Meeting

By Alia Luz, Health Intervention and Technology Assessment Program (HITAP)

With the introduction of the Universal Health Coverage (UHC) in Asian countries, priority-setting and HTA has become increasingly important.  However, only in the past decade has HTA been used to inform countries’ health programs and policies. As such, HTA agencies are relatively new in Asia.  In 2007, the Health Intervention and Technology Assessment Program (HITAP) was established in Thailand. Consecutively in 2008, a HTA division was established in Taiwan’s Center for Drug Evaluation (CDE) and the National Evidence-based healthcare Collaborating Agency (NECA) was founded in Korea.

Combating the global increase of chronic diseases with effective policies: International Forum on Peritoneal Dialysis (PD) as a Priority Health Topic in Asia

By: Alia Luz, Health Intervention and Technology Assessment Program (HITAP)

In 2007, there were an estimated 58 million deaths worldwide and, according to the WHO, more than half (35 million) were caused by chronic diseases. Another study estimates that deaths caused by chronic diseases will rise to 50 million in 2020. The economic burden of these diseases is enormous. By 2015, an estimated reduction of 5% on GDP will be due to funds channeled into healthcare spending on just two of these diseases – diabetes and cardiovascular disease. Studies show that low- and middle-income countries, elderly patients, and those coming from lower income brackets bear the brunt of the increasing risk and economic burden of these diseases. Despite this, chronic kidney disease (CKD) is generally not included in the list of priorities for governments and international donors. And with governments around the world committing to Universal Health Coverage (UHC) for their citizens, priority-setting for treatments of chronic diseases – and CKD – is a must.

An American pre-medical student explores Universal Health Coverage…

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.

Why do (and should) we do economic evaluation?

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.

The Power of HTA: an animation

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.

A potential indicator for measuring the success of HTA development

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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Finding the true north of evidence-based policy development

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.

Prof David Haslam, Chair of NICE, speaks at the 67th World Health Assembly in support of priority-setting for UHC

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.

iDSI launches global public good: questionnaire on priority-setting readiness

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).

Event on 17 June, Washington DC: Improving the Use of Economic Evaluation for Global Health Funders

As part of a series of events coinciding with the launch of the Gates Reference Case, Tommy Wilkinson (Adviser for Health Economics, NICE International) will be speaking on Tuesday 17 June 2014 at a lunch seminar hosted by the Center for Global Development, Washington DC. If you missed our launch event in London or are attending the HTAi conference, here’s your chance to find out why the Gates RC is important for global health funders, policymakers and researchers alike; and how it will help improve the quality of economic evaluations to ensure that limited resources in health are invested in the best possible way. All are welcome to join the discussion on Twitter using #GatesRC hashtag!

Location, Date & Time

Center for Global Development

2055 L St NW – Fifth Floor

Washington, DC 20036

(Map)

Tuesday, June 17, 2014
1:00 p.m. to 2:30 p.m.

See CGD event page for further information