Health Technology Assessment: Global Advocacy and Local Realities; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”

Document Type : Commentary

Authors

1 Institute of Global Health Innovation, Imperial College London, London, UK

2 Department of Economics & Related Studies and Centre for Health Economics, University of York, York, UK

3 Center for Global Development, Washington, DC, USA

4 School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

5 Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand

Abstract

Cost-effectiveness analysis (CEA) can help countries attain and sustain universal health coverage (UHC), as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evidence about local values), whilst striving to strengthen the governance structures and technical capacities with which to generate, consider and act on such evidence. In low- and middle-income countries (LMICs), such capacities could be developed initially around a small technical unit in the health ministry or health insurer. The role of networks, development partners, and global norm setting organisations is crucial in supporting the necessary capacities.

Highlights

 

 

Watch the Video Summary here. 

 

Keywords

Main Subjects

Full Text

 

 

References

  1.  

    1. Balthussen R, Jansen MP, Mikkelsen E, et al. Priority setting for universal health coverage: we need evidence-informed deliberative processes, not just more evidence on cost-effectiveness. Int J Health Policy Manag. 2016; forthcoming.  doi:10.15171/ijhpm.2016.83
    2. Lomas J, Culyer T, McCutcheon C, McAuley L, Law S. Conceptualizing and Combining Evidence for Health System Guidance. Ontario: Canadian Health Services Research Foundation; 2005.
    3. Culyer AJ, Lomas J. Deliberative processes and evidence-informed decision making in healthcare: do they work and how might we know? Evidence & Policy: A Journal of Research, Debate and Practice. 2006;2(3):357-371. doi:10.1332/174426406778023658
    4. Culyer AJ. Involving stakeholders in healthcare decisions--the experience of the National Institute for Health and Clinical Excellence (NICE) in England and Wales. Healthc Q. 2005;8(3):56-60. doi:10.12927/hcq..17155
    5. Canadian Agency for Drugs and Technologies in Health (CADTH). From CCOHTA to CADTH... Evolution to an Agency. Annual Report 2005-2006. http://www.cadth.ca/media/pdf/cadth_annual_05-06_e.pdf. Published 2006.
    6. Ahn J, Kim G, Suh HS, Lee SM. Social values and healthcare priority setting in Korea. J Health Organ Manag. 2012;26(3):343-350. doi:10.1108/14777261211238981
    7. Teerawattananon Y, Tantivess S, Yothasamut J, Kingkaew P, Chaisiri K. Historical development of health technology assessment in Thailand. Int J Technol Assess Health Care. 2009;25(Suppl 1):241-252. doi:10.1017/s0266462309090709
    8. Glassman A, Chalkidou K. Priority-Setting in Health: Building Institutions for Smarter Public Spending. http://www.cgdev.org/publication/priority-setting-health-building-institutions-smarter-public-spending. Published 2012.
    9. Pereira VC, Salomon F, Souza A, Santos VC, Petramale C. Health technology assessment tools for technologies incorporation into public health system. Value Health. 2015;18(7):A560. doi:10.1016/j.jval.2015.09.1819
    10. World Health Organization (WHO). Cost effectiveness and strategic planning (WHO-CHOICE). http://www.who.int/choice/en/. Accessed July 18, 2016. Published 2016.
    11. University of Washington Department of Global Health. DCP3 - About the Project. http://dcp-3.org/about-project. Accessed July 18, 2016. Published 2016.
    12. Chalkidou K, Glassman A, Marten R, et al. Priority-setting for achieving universal health coverage. Bull World Health Organ. 2016;94(6):462-467. doi:10.2471/blt.15.155721
    13. Schreyögg J, Stargardt T, Velasco-Garrido M, Busse R. Defining the “Health Benefit Basket” in nine European countries: Evidence from the European Union Health BASKET Project. Eur J Health Econ. 2005;6(Suppl 1):2–10. doi:10.1007/s10198-005-0312-3
    14. Glassman A, Giedion U, Sakuma Y, Smith PC. Defining a health benefits package: what are the necessary processes? Health Systems & Reform. 2016;2(1):39-50. doi:10.1080/23288604.2016.1124171
    15. Dittrich R, Cubillos L, Gostin L, Chalkidou K, Li R. The international right to health: what does it mean in legal practice and how can it affect priority setting for universal health coverage? Health Systems & Reform. 2016;2(1):23-31. doi:10.1080/23288604.2016.1124167
    16. Dittrich R. Healthcare priority setting in the courts. A reflection on decision-making when healthcare priority setting is brough to court. Working paper version 2; 2016.
    17. Gaviria A. Cost of Progress. Finance & Development. 2014;51(4). http://www.imf.org/external/pubs/ft/fandd/2014/12/gaviria.htm
    18. . REVISE 2020 - REthinking the Valuation of Interventions to improve priority SEtting. NICHE  website.http://www.niche1.nl/projects/id=34/title=revise_2020_rethinking_the_valuation_of_interventions_to_improve_priority_setting. Accessed July 18, 2016. Published 2016.
    19. Better decisions. Better health. iDSI  website. http://www.idsihealth.org/. Accessed July 11, 2016. Published 2016.
    20. Chalkidou K, Levine R, Dillon A. Helping poorer countries make locally informed health decisions. BMJ. 2010;341:c3651. doi:10.1136/bmj.c3651
    21. Revill P, Asaria M, Phillips A, Gibb DM, Gilks CF. WHO Decides What is Fair? International HIV Treatment Guidelines, Social Value Judgements and Equitable Provision of Lifesaving Antiretroviral Therapy. CHE Research Paper 99; 2014.
    22. Marseille E, Larson B, Kazi DS, Kahn JG, Rosen S. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ. 2015;93(2):118-124. doi:10.2471/blt.14.138206
    23. Woods BS, Revill P, Sculpher MJ, Claxton KP. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value Health. 2016.
    24. Gray AM, Wilkinson T. Economic evaluation of healthcare interventions: old and new directions. Oxf Rev Econ Policy. 2016;32(1):102-121. doi:10.1093/oxrep/grv020
    25. Li R, Hernandez-Villafuerte K, Towse A, Vlad I, Chalkidou K. Mapping Priority setting in health in 17 countries across Asia, Latin America, and sub-Saharan Africa. Health Systems & Reform. 2016;2(1):71-83. doi:10.1080/23288604.2015.1123338
    26. Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world converging within a generation. Lancet. 2013;382(9908):1898-1955. doi:10.1016/s0140-6736(13)62105-4
    27. Wilkinson T, Claxton KP, Sculpher MJ, et al. The International Decision Support Initiative Reference Case for Economic Evaluation: an aid to thought. Value Health. 2016. https://pure.york.ac.uk/portal/en/publications/the-international-decision-support-initiative-reference-case-for-economic-evaluation(d0bf054f-74ea-4463-98b3-03bd7df0a0a4)/export.html
    28. Dieleman JL, Hanlon M. Measuring the displacement and replacement of government health expenditure. Health Econ. 2014;23(2):129-140. doi:10.1002/hec.3016
    29. Manikandan S. Are we moving towards a new definition of essential medicines? J Pharmacol Pharmacother. 2015;6(3):123-125. doi:10.4103/0976-500x.162008
    30. Culyer AJ. Cost-effectiveness thresholds in health care: a bookshelf guide to their meaning and use. Health Econ Policy Law. 2016; forthcoming. doi:10.1017/s1744133116000049
    31. Daniels N. Accountability for reasonableness. BMJ. 2000;321(7272):1300-1301. doi:10.1136/bmj.321.7272.1300
    32. World Health Assembly. Health intervention and technology assessment in support of universal health coverage. Geneva: World Health Organization; 2010.  http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R23-en.pdf
    33. Chootipongchaivat S, Tritasavit N, Luz A, Teerawattananon Y, Tantivess S. Policy Brief and Working Paper. Conducive factors to the development of health technology assessment in Asia. http://www.idsihealth.org/wp-content/uploads/2016/02/CONDUCIVE-FACTORS-TO-THE-DEVELOPMENT_resize.pdf. Published 2015.
    34. Chalkidou K, Marten R, Cutler D, et al. Health technology assessment in universal health coverage. Lancet. 2013;382(9910):e48-e489. doi:10.1016/s0140-6736(13)62559-3

Files

History

  • Receive Date: 23 July 2016
  • Revise Date: 29 August 2016
  • Accept Date: 17 August 2016
  • First Publish Date: 01 April 2017

Share

How to cite

Statistics