Resource allocation and health technology assessment in Australia: Views from the local level

Abstract

Although there are renewed initiatives in HTA in Australia, there is a risk that such investments will not be productive unless policy makers also examine the decision-making contexts within which HTA can successfully be implemented. The results of this survey show that this is especially true at the local level and that any HTA initiative should be accompanied by efforts to improve decision-making processes.

The development of funding recommendations for health technologies at the state level: A South Australian case study

“…The discussion follows the logic of the research focus with consideration given to criteria, evidence, and then standards. Research from the institutional and local health network level in NSW and around the world is consistent in finding that safety and effectiveness are considered the most important criteria in health technology funding decision making.…”

“…There is a large volume of research from around the world that has found economic evaluations to be under‐utilised by local decision makers, including in Canada, the United States, England, and Australia . This volume of research is also consistent with the finding of studies describing decision‐making processes at the local level in the Australian state of NSW . Sub‐national bodies in Australia differ from national bodies such as PBAC and MSAC in that national bodies have come to require economic evidence as part of submissions and thus will not recommend a technology without economic evidence.…”

“…Such technologies represent a challenge for all states, but there is no comprehensive interjurisdictional approach to their funding . This is particularly important when making decisions at meso‐levels or micro‐levels, because they often face greater budget constraints than national funding bodies (eg, they may have capped budgets) …”

“…The review indicated that, at least with respect to medicines for paediatric patients, about which evidence can be especially difficult to generate for ethical reasons, the national and sub‐national approaches to evaluating health technologies are dissimilar. A complete picture of the dissimilarities is lacking, however, because research examining decision making in Australia at sub‐national levels is limited in volume and has overwhelmingly been conducted in the Australian state of New South Wales (NSW) . These studies have documented a complex situation in NSW, characterised by: limited resources available for HTA; inconsistent processes for the introduction, diffusion and prioritisation of technologies; and an overall paucity of evidence for assessment.…”

Hospital-Based Health Technology Assessment: Developments to Date

“…Members of internal HTA committees do not normally exercise this activity full-time, and the committees themselves are not dedicated to this activity alone. This model is commonly used in the USA and has also been reported in other countries, such as Australia, Sweden and Canada [10,16,17].…”