Post-Introduction Observation of Healthcare Technologies After Coverage: The Spanish Proposal

Varela-Lema, Leonor; Ruano-Raviña, Alberto; Mota, Teresa Cerdá; Ibargoyen-Roteta, Nora; Imaz, Iñaki Arratibel; Gutiérrez-Ibarluzea, Iñaki; Blasco‐Amaro, Juan Antonio; Soto-Pedre, Enrique; Sampietro-Colom, Laura

doi:10.1017/s0266462312000232

Cited by 8 publications

(10 citation statements)

References 18 publications

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“…These data are in conformance to the primary concern of the health systems from France, Australia, New Zealand, Canada and the UK, that is, to identify safety and efficacy problems that were not previously identified or underestimated in a randomized clinical trial [25]. Besides, the HTR has been used in others countries to assess the degree of adoption and usage of technology and, to provide the real costs and the use of health technologies resources in real settings [38].…”

Section: Discussionmentioning

confidence: 99%

Health technology reassessment in the Brazilian public health system: Analysis of the current status

2019

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Background The reassessment of technologies and services offered by healthcare systems is recent initiative and still without a widely adopted and evaluated method. To a better understanding of this process in Brazil, we have described the health technology reassessment (HTR) performed by the National Committee for Health Technology Incorporation (Conitec) into Brazilian public health system (SUS). Methods A documental, exploratory, descriptive, retrospective study with qualitative-quantitative approach regarding the HTR performed by Conitec from January 2012 to November 2017. Results After applying the criteria of inclusion and exclusion, we selected 47 technologies for this study. The vast majority of the demands (41 demands) came from the public sector, and only six from the private sector. Most of the requests referred to the exclusion of specific indication; followed by extension of use, withdraw of the technology from SUS, maintenance, and restriction of use. The dimensions of analysis found in the recommendation reports were scientific evidence on efficacy, effectiveness and safety, disease-related issues, issues related to the use of technology, costs, and social participation. However, these dimensions were not included in all analysis, and a standardized structure of the reports has not been observed. The most relevant decision factors considered for decision-making were efficacy, safety and use of the technology. Conclusion During a six-year period of Conitec actuation, we could find some reassessments of technologies that are available in SUS. We observed that these activities had enabled progress, however, they are still not yet structured, with gaps in the selection process, and the assessment since no methodology and criteria for proper conduct were established.

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Section: Discussionmentioning

confidence: 99%

Health technology reassessment in the Brazilian public health system: Analysis of the current status

2019

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“…18 Reliance on a single methodologic approach may provide an answer with a narrow perspective and this is unlikely to be in the patient's best interest. 3 A variety of assessment methodologies, designed by a range of stakeholders, is likely to represent the best way of monitoring a complex health care technology implementation plan.…”

Section: Discussionmentioning

confidence: 99%

How Satisfied Are Patients When Their Choice of Funded Glucose Meter Is Restricted to a Single Brand?

Macdonald

Lunt

Downie

et al. 2017

J Diabetes Sci Technol

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Background: Many governments and insurers are driving down the cost of medical devices, including glucose meters, by the central management of purchasing decisions. We report patients' responses to an "enforced" change in brand of glucose meter, one year after the introduction of a national sole supplier arrangement for funded glucose meters and strips.Method: Specialist diabetes clinic attendees from two geographical locations completed a questionnaire one year after the final meter changeover date. In the first location, consecutive patients were asked to complete a glucose meter satisfaction questionnaire during their clinic visit. In the second location, this questionnaire was mailed to clinic attendees. Responses to open questions were analyzed thematically. Results:Response rates were 85% and 31% from the first and second locations, respectively and 378 questionnaires were suitable for analysis, 309 from the first and 69 from the second location. Insulin users composed 90% of participants. Results from the two locations were broadly similar. Most participants adapted well to the changeover, however 36% reported ongoing dissatisfaction with their "new" meter. The commonest concern, expressed by 23% of participants, related to meter accuracy and precision.Conclusions: One year after glucose meter changeover, a third of participants expressed dissatisfaction with their meter, with many participants describing a failure to adapt to the sole supplier arrangement. Providing a choice of meters and strips, ideally from two or more brands that have demonstrable differences in technical and ergonomic features, is likely to produce higher overall patient satisfaction than is a sole supplier arrangement.

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“…Additionally, the variability in practice, the irrational or inadequate use of health technologies, the wide range of health professionals, and the lack of required competencies to achieve the desired outcomes may also lead to an inefficient use of investments, a spendthrift of services, and the lack of funds vital for purchasing other more priority resources for Health Systems. HTA could be helpful at this stage by anticipating the possible impact and requirements of health technologies included in different health care systems, what it has been called “Early Awareness and Alert Systems” (Packer et al, 2012) and by promoting evidence generation post-marketing authorization and reimbursement decision (Varela-Lema et al, 2012). As previously mentioned, the value of health technologies in routine care differs from that promised in theory and according to trials in ideal conditions.…”

Section: Investmentmentioning

confidence: 99%

“…However, having in mind its definition and privileged position, HTA activities have evolved to more constructive approaches from health technology inception to its obsolescence (Henshall et al, 2011). New concepts such as scientific advice (Jost et al, 2015), early dialogue, early awareness, and alert systems (Packer et al, 2012), post-introduction observation of health technologies (Varela-Lema et al, 2012), appropriateness, re-assessment, and disinvestment (Elshaug et al, 2007) have gained ground.…”

mentioning

confidence: 99%

The Life Cycle of Health Technologies. Challenges and Ways Forward

Gutiérrez-Ibarluzea

Chiumente²,

Dauben

2017

Front. Pharmacol.

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Post-Introduction Observation of Healthcare Technologies After Coverage: The Spanish Proposal

Cited by 8 publications

References 18 publications

Health technology reassessment in the Brazilian public health system: Analysis of the current status

Health technology reassessment in the Brazilian public health system: Analysis of the current status

How Satisfied Are Patients When Their Choice of Funded Glucose Meter Is Restricted to a Single Brand?

The Life Cycle of Health Technologies. Challenges and Ways Forward

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