Establishment and implementation of hospital-based health technology assessment at King Hussein Cancer Center: can our model be an example?

Abstract

Objective To describe the establishment of, and assess the implementation of, a hospital-based health technology assessment (HTA) program in a comprehensive cancer center in Jordan. Methods This is a cross-sectional assessment study of the HTA program from 2008 to 2018. We used an indicator-based assessment that included structural, process, and outcome indicators. Structural indicators measured the program's enablers. Process indicators measured activities and outputs, whereas outcome indicators measured the program impact. A data collection form was prepared to collect data related to each indicator. Results The program met its core structural and process indicators. The Center for Drug Policy and Technology Assessment was established as an organizational entity to conduct assessments. A functional decision-making entity is available. There are competent pharmacists to conduct assessments, including economic evaluation and decision analytical modeling. There is a structured capacity building program that has been implemented within the last 5 years. Specific submission, assessment, and appraisal processes were established and implemented. Reference methodological guidelines for efficacy, safety, and cost-effectiveness assessments were developed and used by assessors. Thirty-one HTA reports were produced from 2012 to 2018 with a 100 percent utilization rate. Twenty-three medications were listed under restriction, and eight were rejected. The prices of twenty-one medications out of the twenty-three listed medications were reduced based on the HTA assessment results. Conclusion The HTA program at the King Hussein Cancer Center (KHCC) in Jordan is functional, is effective with a high utilization rate of produced assessments, and is having a positive impact on price reductions.

Impact of a New Cost-Effectiveness Threshold Implementation on Cancer Formulary Decisions in Jordan

“…Effective 2006, all new formulary requests for novel cancer medications would be subjected to cost-effectiveness (CE) assessment. KHCC established the Center for Drug Policy and Evaluation (CDPTA) to conduct pharmacoeconomic analyses and conduct and appraise CE studies [ 19 ]. In 2012, a formulary submission pathway targeting pharmaceutical manufacturers was introduced under the formulary system policy.…”

“…The CDPTA presents its CE assessment report to the P&T. The report is based on a standardized template that addresses clinical pharmacology, clinical efficacy/effectiveness, safety, and economic evaluation along with expected resource utilization. The results of the adapted CE model, along with assessments of uncertainty and resource implications, are included in the economic evaluation section [ 19 ]. The P&T may authorize the pharmacy department to initiate negotiations with the manufacturers to reduce acquisition costs in line with the CET.…”

Overcoming Barriers in Hospital-Based Health Technology Assessment (HB-HTA): International Expert Panel Consensus

“…The evidence supports the positive impact of HB-HTA on decision-making quality, hospital budgets, procurement, the utilization of new health technologies, and potential costs savings, such as lower purchase prices of pharmaceuticals when considering therapeutic equivalents (biosimilars) or generics in the assessments. Although HB-HTA is well regarded by managers and clinicians [20,[34][35][36], its widespread adoption across countries is hindered by the entrenched healthcare system traditions and the historical centralization of HTA [37].…”