Decision-making in the health technology assessment system: basic approaches, criteria, and conditions
DOI:
https://doi.org/10.24959/sphhcj.25.360Keywords:
expert advisory processes; information support; criteria; critical assessment; health technology assessment; decision-makingAbstract
The development of the health technology assessment in Ukraine involves not only its wider implementation in medical and pharmaceutical practice, but also the mandatory use of its results to substantiate decisions on the rational use of medicines and cost optimization.
Aim. To study the peculiarities of organizing expert and advisory processes in the system of the health technology assessment, in particular, methodological approaches, criteria, and conditions for decision-making based on it.
Materials and methods. Using a systematic approach, the analysis, generalization and systematization of data from scientific publications, analytical and reporting documents were carried out. A survey of medical and pharmaceutical workers was conducted on the use of results of the health technology assessment in practical activities.
Results and discussion. The analysis shows significant differences in the organization of the health technology assessment and critical evaluation of its results (appraisal) for decision-making based on it. A survey of physicians and pharmacists revealed the main approaches, criteria, and conditions for evidence-based decision-making and their information support. The survey results indicate the insufficient use of the health technology assessment results in practice due to lack of time, inaccessibility of resources, and the absence of relevant knowledge and skills. Respondents are guided primarily by regulatory documents (protocols, guidelines, forms), relying on their own experience and the expert opinion. At the same time, specialists are aware of the importance of assessment for selecting optimal health technologies and improving the efficiency of medical and pharmaceutical care.
Conclusions. The development of theoretical and methodological approaches to the organization of expert and advisory processes, the involvement of stakeholders, the use of information sources, analytical tools for their critical assessment, and processing tools is an important step in the implementation of the health technology assessment at various levels of management.
References
Kostiuk, I. A., Filiniuk, O. M., Liaskovskyi, T. M., Hryshchenko, V. M., Ditkivskyi, I. O., Voloshyn, D. V., Yakovets, V. S., Unitska, O. M., Kosiachenko, K. L., & Sudzhu, R. (2024). Hospitalna otsinka medychnykh tekhnolohii v Ukraini: rezultaty pilotnoho proiektu ta rekomendatsii dlia podalshoho vprovadzhennia. Ukrainian Medical Journal, 165(7). https://doi.org/10.32471/umj.1680-3051.165.260664
HTA systems in Europe. (2016). EUPATI Toolbox. https://toolbox.eupati.eu/resources/hta-systems-in-europe/
Gsteiger, S., Bucher, H. C., Ryan, J., & Ruof, J. (2024). Technology Assessment vs. Technology Appraisal—How to Strengthen the Science/Value Dichotomy with EU HTA? Journal of Market Access & Health Policy, 12(4), 369–377. https://doi.org/10.3390/jmahp12040028
Bond, K., Stiffell, R., & Ollendorf, D. A. (2020). Principles for deliberative processes in health technology assessment. International Journal of Technology Assessment in Health Care, 36(4), 445–452. https://doi.org/10.1017/s0266462320000550
HTA & Relative Efficacy Assessment. (б. д.). EFPIA Homepage. https://www.efpia.eu/about-medicines/use-of-medicines/hta-relative-efficacy-assessment/
Fontrier, A.-M., Visintin, E., & Kanavos, P. (2021). Similarities and Differences in Health Technology Assessment Systems and Implications for Coverage Decisions: Evidence from 32 Countries. PharmacoEconomics – Open, 6, 315–328. https://doi.org/10.1007/s41669-021-00311-5
Babenko, M. M., Nazarkina, V. M., Nemchenko, A. S., & Kosiachenko, K. L. (2023). Naukove uzahalnennia pidkhodiv do rozvytku systemy otsinky medychnykh tekhnolohii u mizhnarodnii praktytsi. Farmatsevtychnyi zhurnal, 78(4), 46–61. https://doi.org/10.32352/0367-3057.4.23.05
Babenko, M. M. (2024). Priorytetni napriamy rozvytku systemy otsinky medychnykh tekhnolohii v Ukraini: rezultaty opytuvannia. Sotsialna farmatsiia v okhoroni zdorovia, 10(2), 12–22. https://doi.org/10.24959/sphhcj.24.321
Filiniuk, O. M., Aleshko, D. V., Babenko, M. M., Kosiachenko, K. L., & Kakhvechi, R. (2022). Decision-making regulatory framework of the introduction of health technologies at the hospitals in Ukraine. Farmatsevtychnyi zhurnal, (1), 6–14. https://doi.org/10.32352/0367-3057.1.22.01
Babenko, M. M. (2024). Ekspertna otsinka stanu ta problem vprovadzhennia otsinky medychnykh tekhnolohii v Ukraini. Farmatsevtychnyi zhurnal, 79(4), 18−28. https://doi.org/10.32352/0367-3057.4.24.02
Babenko, M. M., & Kosiachenko, K. L. (2025). Ekspertna otsinka priorytetnykh napriamiv vprovadzhennia medychnykh i farmatsevtychnykh tekhnolohii v Ukraini. Zaporizkyi medychnyi zhurnal, 27(1), 73−79. https://doi.org/10.14739/2310- 1210.2025.1.315813
HtaGlossary. (б. д.). http://htaglossary.net/
Angelis, A., Lange, A., & Kanavos, P. (2017). Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries. The European Journal of Health Economics, 19(1), 123–152. https://doi.org/10.1007/s10198-017-0871-0
Patera, N., & Wild, C. (2014). Assessment – APPRAISAL – Decision. LBI-HTA Decision Support Document Nr. 72. Ludwig Boltzmann Institut für Health Technology Assessment. https://eprints.aihta.at/1036/1/DSD_72.pdf
Sandman L., & Heintz E. (2014). Assessment vs. appraisal of ethical aspects of health technology assessment: Can the distinction be upheld? GMS Health Innovation and Technologies, (10), doi: 10.3205/hta000121
Wranik, W. D., Jakubczyk, M., & Drachal, K. (2020). Ranking the Criteria Used in the Appraisal of Drugs for Reimbursement: A Stated Preferences Elicitation With Health Technology Assessment Stakeholders Across Jurisdictional Contexts. Value in Health, 23(4), 471–480. https://doi.org/10.1016/j.jval.2019.10.012
Richardson, M., Mittmann, N., & Kaunelis, D. (б. д.). Deliberative Appraisal Processes in Health Technology Assessment. Environmental Scan. CADTH Health Technology Review. https://www.canjhealthtechnol.ca/index.php/cjht/article/download/nm0001/129?inline=1#fig01
Alonso-Coello, P., Schünemann, H. J., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Rada, G., Rosenbaum, S., Morelli, A., Guyatt, G. H., & Oxman, A. D. (2016). GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ, 353. https://doi.org/10.1136/bmj.i2016
Kanavos, P. (2013). Multiple Criteria Decision Analysis for Value Based Assessment of New Medical Technologies: A Conceptual Framework. LSE Health. London School of Economics and Political Science, 33, 1–16.
Angelis, A., & Kanavos, P. (2013). A Multiple Criteria Decision Analysis Framework For Value Based Assessment Of New Medical Technologies. Value in Health, 16(3), A53. https://doi.org/10.1016/j.jval.2013.03.302
Angelis, A., & Kanavos, P. (2016). Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment. PharmacoEconomics, 34(5), 435–446. https://doi.org/10.1007/s40273-015-0370-z
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