Key principles for the improved conduct of health technology assessments for resource allocation decisions

Abstract

Health technology assessment (HTA) is a dynamic, rapidly evolving process, embracing different types of assessments that inform real-world decisions about the value (i.e., benefits, risks, and costs) of new and existing technologies. Historically, most HTA agencies have focused on producing high quality assessment reports that can be used by a range of decision makers. However, increasingly organizations are undertaking or commissioning HTAs to inform a particular resource allocation decision, such as listing a drug on a national or local formulary, defining the range of coverage under insurance plans, or issuing mandatory guidance on the use of health technologies in a particular healthcare system. A set of fifteen principles that can be used in assessing existing or establishing new HTA activities is proposed, providing examples from existing HTA programs. The principal focus is on those HTA activities that are linked to, or include, a particular resource allocation decision. In these HTAs, the consideration of both costs and benefits, in an economic evaluation, is critical. It is also important to consider the link between the HTA and the decision that will follow. The principles are organized into four sections: (i) "Structure" of HTA programs; (ii) "Methods" of HTA; (iii) "Processes for Conduct" of HTA; and (iv) "Use of HTAs in Decision Making."

Towards a more comprehensive approach for a total economic assessment of vaccines?

“…It is part of the Health Technology Assessment (HTA) programmes, which include issues such as clinical effectiveness, safety and cost-effectiveness within a broad field of social, ethical and legal aspects required for a new intervention to obtain local approval of reimbursement [2]. Within that framework, the economic method currently most used for the evaluation of vaccines is the incremental cost–utility analysis (ICUA), which was developed for the evaluation of new therapeutic interventions such as drug treatments [3–7].…”

Orphan drugs policies: a suitable case for treatment

“…However, with the growth in the use of health technology assessment (HTA) to control the adoption and diffusion of health technologies [2], current orphan drug policies are increasingly being viewed as unsatisfactory from almost all perspectives. The payers for health care find that, because of their high prices, most orphan drugs do not justify funding based on cost-effectiveness, but payers often face political problems if they fail to give approval for funding.…”

Priority-setting and rationing in healthcare: Evidence from the English experience

“…The priority-setting literature contains many discussions of the best way to organise effective and explicit resource allocation systems. The limitations of a purely technical approach to priority-setting have been recognised and the focus has now shifted to how information, evidence and other inputs can most usefully be deployed (Drummond et al, 2008;Peacock et al, 2009). …”