Health technology assessment: features of national / regional and hospital-based medical technology assessment

Authors

DOI:

https://doi.org/10.24959/sphhcj.21.230

Keywords:

health technology assessment (HTA); national / regional HTA; hospital-based HTA

Abstract

The State Budget of Ukraine in 2021 is 159,2 billion UAH. It is 36.8 % more than in 2020, but this amount is still insufficient to cover all the healthcare needs in Ukraine. Economic hardships, the lack of funds in the healthcare system of Ukraine, as well as COVID-19 pandemic have increased the importance of Health Technology Assessment (HTA) as a tool of cost optimization. The introduction of hospital-based HTA along with national / regional HTA allows providing the use of effective, safe and economically justified health technologies that will give our citizens the access to treatment and the rational use of funds, in particular the budget ones.

Aim. To analyze the world experience of using hospital-based HTA and its main differences from national / regional HTA. Materials and methods. The scientific information of international and domestic literary sources was analyzed. The methods of content analysis, historical, system-analytical and generalization were used during the research.
Results. The authors reviewed the literature in Pubmed and Google Scholar databases devoted to the international experience of hospital-based HTA and its main differences from national / regional HTA. It has been determined that the transfer of the national / regional HTA results to the hospital level is hindered by a number of differences between the country as a whole and hospitals in particular. These include, first of all, features related to demographic indicators, epidemiology of diseases, the level of resistance, local approaches to treatment, various types of equipment used in hospitals, and others. In order to have practical benefits, HTA must be built taking into account the peculiarities of a medical institution where the health technologies studied will be used in the future.
Conclusions. The need of effective management of hospital resources when a number of health technologies is increasing, the desire to improve clinical outcomes, improve the quality of life and its expectancy using health technologies with the proven effectiveness and safety, the need to evaluate medical equipment and consider organizational aspects related to introduction of a health technology, as well as assess the current equipment and treatment methods require to develop the scientific and practical approaches to hospital-based HTA and recommendations on collaboration between national / regional and hospitalbased HTA in Ukraine.

References

Exploring the thresholds of health expenditure for protection against financial risk / К. Xu et al. World health report. Background paper. 2010. No. 19. URL: https://www.who.int/healthsystems/topics/financing/healthreport/19THE-thresv2.pdf.

Current Health Expenditure (% of GDP). World Health Organization Global Health Expenditure database. URL: https://apps.who.int/nha/database.

Про державні фінансові гарантії медичного обслуговування населення : Закон України від 01.01.2021 р. № 2168–VIII. (ст. 4, п. 5). URL: https://zakon.rada.gov.ua/laws/show/2168-19#Text.

Про Державний бюджет України на 2021 рік : Закон України від 01трав. 2021 р. № 1082–IX. URL: https://zakon.rada.gov.ua/laws/show/1082-20#Text.

Health expenditure and financing, % of GDP. OECD.Stat. 2019. URL: https://stats.oecd.org/index. aspx?datasetcode=sha.

Витрати на охорону здоров’я і доступ до лікування в Україні. Висновки з дослідження та рекомендації для покращення ситуації / KSE та IQVIA за підтримки ACC та APRaD. 2020. URL: http://publications.chamber.ua/2020/HCC/ACC_APRaD_Presentation_UPD_12.12_final.pdf.

Hospital Based Health Technology Assessment World-Wide Survey / А. Cicchetti et al. 2008. URL: https://htai.org/wp-content/uploads/2018/02/HospitalBasedHTAISGSurveyReport.pdf.

Guiding principles for good practices in hospital-based health technology assessment units / L. SampietroСolom et al. International Journal of Technology Assessment in Health Care. 2015. Vol. 31, Iss. 6. P. 457–465. DOI: https://doi.org/10.1017/S0266462315000732.

The AdHopHTA handbook: A handbook of hospital-based Health Technology Assessment (HB-HTA) / eds. I. Pasternack, L. Sampietro‑Colom, J.‑B. Wasserfallen. 2015. URL: http://www.adhophta.eu/sites/files/adhophta/media/adhophta_handbook_website.pdf.

Grenon X., Pinget C., Wasserfallen J. Hospital-Based Health Technology Assessment (HB-HTA): A 10-year survey at one unit. International Journal of Technology Assessment in Health Care. 2016. Vol. 32, Iss. 3. P. 161–121. DOI: https://doi.org/10.1017/S0266462316000258.

Hospital-based Health Technology Assessment in Kazakhstan: 3 years’ experience of one unit / A. Avdeyev et al. International Journal of Technology Assessment in Health Care. 2019. Vol. 35, Iss. 6. P. 436–440. DOI: https://doi.org/10.1017/S0266462318003744.

Tal O., Booch M., Bar-Yehuda S. Hospital staff perspectives towards health technology assessment: data from a multidisciplinary survey. Health Research Policy and Systems. 2019. Vol. 17, Iss. 72. DOI: https://doi.org/10.1186/s12961-019-0469-3.

Halmesmäki E., Pasternack I., Roine R. Hospital-based health technology assessment (HTA) in Finland: a case study on collaboration between hospitals and the national HTA unit. Health Research Policy and Systems. 2016. Vol. 14, Iss. 25. DOI: https://doi.org/10.1186/s12961-016-0095-2.

Local health technology assessment in Canada: current state and next steps / J. Martin et al. International Journal of Technology Assessment in Health Care. 2016. Vol. 32, Iss. 3. Р. 175–180. DOI: https://doi.org/10.1017/S0266462316000210.

Doing mini–health technology assessments in hospitals: A new concept of decision support in health care? / L. Ehlers et al. International Journal of Technology Assessment in Health Care. 2006. Vol. 22, Iss. 3. P. 295–301. DOI: https://doi.org/10.1017/S0266462306051178.

Mamana J. P. Technology evaluation in the hospital setting: starting from the bottom up. The Hospital medical staff. 1979. Vol. 8, Iss. 7. P. 7–9. URL: https://pubmed.ncbi.nlm.nih.gov/10242675/.

The new definition of health technology assessment: A milestone in international collaboration / В. O’Rourke et al. International Journal of Technology Assessment in Health Care. 2020. Vol. 36, Iss. 3. P. 187–190. DOI: https://doi.org/10.1017/S0266462320000215.

Порядок проведення державної оцінки медичних технологій : Постанова КМУ від 23.12.2020 р. № 1300. URL: https://www.kmu.gov.ua/npas/pro-zatverdzhennya-poryadku-provedennya-derzhavnoyiocinki-medichnih-tehnologij-1300-231220.

Оценка медицинских технологий и формирование политики здравоохранения в странах Европы: Современное состояние, проблемы и перспективы / M. V. Garrido et al. Всемирная организация здравоохранения. Европейское региональное бюро. 2010. URL: https://apps.who.int/iris/handle/10665/276988.

Звіт про етап розвитку оцінки медичних технологій в Україні / Департамент ОМТ ДЕЦ МОЗ України. Київ, 2019. URL: https://www.dec.gov.ua/materials/zvit-pro-etap-rozvytku-oczinky-medychnyh-tehnologij-v-ukrayini-gruden-2019/.

Про затвердження Порядку проведення державної оцінки медичних технологій : Постанова КМУ від 23 груд. 2020 р. № 1300. URL: https://www.kmu.gov.ua/npas/pro-zatverdzhennya-poryadku-provedennya-derzhavnoyi-ocinki-medichnih-tehnologij-1300-231220.

Деякі питання щодо договорів керованого доступу : Постанова КМУ від 27 січ. 2021 р. № 61. URL: https://zakon.rada.gov.ua/laws/show/61-2021-п#Text.

Про затвердження Настанови з державної оцінки медичних технологій для лікарських засобів : Наказ МОЗ України від 29.03.2021 № 593. URL: https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-29032021--593-pro-zatverdzhennja-nastanovi-z-derzhavnoi-ocinkimedichnih-tehnologij-dlja-likarskih-zasobiv.

Eunethta Collaboration. URL: https://www.eu-patient.eu/Projects/completed-projects/EUnetHTACollaboration/.

McGregor M., Brophy J. M. End-user involvement in health technology assessment (HTA) development:

a way to increase impact. International Journal Of Technology Assessment In Health Care. 2005. Vol. 21,

Iss. 2. P. 263–267. URL: https://pubmed.ncbi.nlm.nih.gov/15921068/.

Published

2021-10-11

Issue

Section

Health organization