Systematic Review of Tools and Approaches for Evaluating the Transferability of Health Technology Assessments Across Different Jurisdictions

Document Type : Review Article

Authors

1 Health System Observatory Secretariat, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Science, Information and Dissemination, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt

3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background 
This study aims to review tools that have been developed for the transferability of health technology assessment (HTA) information to different countries. HTA is increasingly being used as a tool in health policy decision-making, but its complexity and lack of local expertise have limited its usage in many countries. The World Health Organization (WHO) has taken measures to encourage countries to conduct and use HTA, including through resolutions from the Eastern Mediterranean (EM) Regional Committee in 2019. However, due to limitations in national technical capacities, there is a need to adapt HTA information from other settings to fit the specific context of each country. Therefore, this study aims to systematically review the tools that have been developed for HTA transferability and assess their strengths and limitations.
 
Methods 
The systematic review included studies that introduced tools, methods, and frameworks for transferability of HTA information across jurisdictions. Databases such as MEDLINE, EMBASE, Cochrane Library, Epistemonikos, Web of Science, health economic database, Scopus, and Google Scholar were searched, along with relevant bibliographies. The data was extracted and synthesized using both tabulation and narrative approaches. The evaluation of the tools involved assessing various criteria, such as user-friendliness, efficiency in screening, and considerations regarding transferability factors.
 
Results 
A total of 10 375 documents were evaluated, resulting in 17 studies that met the inclusion criteria. These 17 studies consisted of 13 newly developed tools/methods that were appraised. The majority of the models were checklists, with only a few deemed suitable for full HTA. Three models have been validated through published studies, but there is no evidence of utilization in the countries of the EM region.
 
Conclusion 
While the existing tools provide valuable resources for evaluating transferability, there remains a need for a more comprehensive tool to support decision-makers in low-resource settings considering country context and capacity. 

Keywords

References

  1. Kieny MP, Bekedam H, Dovlo D, et al. Strengthening health systems for universal health coverage and sustainable development. Bull World Health Organ. 2017;95(7):537-539. doi:2471/blt.16.187476
  2. WHO Regional Office for the Eastern Mediterranean (EMRO). Framework for Action to Improve National Institutional Capacity for the Use of Evidence in Health Policy-Making in the Eastern Mediterranean Region. Cairo: EMRO; 2019. https://applications.emro.who.int/docs/EMSID001E.pdf.
  3. Regional action plan for the implementation of the framework for action to improve national institutional capacity for the use of evidence in health policy-making in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean; 2021. https://www.emro.who.int/evidence-data-to-policy/about.html.
  4. Alkhaldi M, Al Basuoni A, Matos M, Tanner M, Ahmed S. Health technology assessment in high, middle, and low-income countries: new systematic and interdisciplinary approach for sound informed-policy making: research protocole. Risk Manag Healthc Policy. 2021;14:2757-2770. doi:2147/rmhp.s310215
  5. Impact of COVID-19 pandemic on HTA. PharmacoEcon Outcomes News. 2020;853(1):2. doi:1007/s40274-020-6797-2
  6. Falkowski A, Ciminata G, Manca F, et al. How least developed to lower-middle income countries use health technology assessment: a scoping review. Pathog Glob Health. 2023;117(2):104-119. doi:1080/20477724.2022.2106108
  7. Heupink LF, Peacocke EF, Sæterdal I, Chola L, Frønsdal K. Considerations for transferability of health technology assessments: a scoping review of tools, methods, and practices. Int J Technol Assess Health Care. 2022;38(1):e78. doi:1017/s026646232200321x
  8. World Health Organization (WHO). 2015 Global Survey on Health Technology Assessment by National Authorities. https://www.who.int/publications/i/item/9789241509749.
  9. Zrubka Z, Rashdan O, Gulácsi L. Health economic publications from the Middle East and North Africa region: a scoping review of the volume and methods of research. Glob J Qual Saf Healthc. 2020;3(2):44-54. doi:36401/jqsh-20-4
  10. Goeree R, He J, O'Reilly D, et al. Transferability of health technology assessments and economic evaluations: a systematic review of approaches for assessment and application. Clinicoecon Outcomes Res. 2011;3:89-104. doi:2147/ceor.s14404
  11. EUnet HTA. Adaptation Toolkit & Glossary. Adapting existing HTAs from one country into other settings. Winchester: NIHR Coordinating Centre for HTA, UK; 2011.
  12. Heyland DK, Kernerman P, Gafni A, Cook DJ. Economic evaluations in the critical care literature: do they help us improve the efficiency of our unit? Crit Care Med. 1996;24(9):1591-1598. doi:1097/00003246-199609000-00025
  13. Späth HM, Carrère MO, Fervers B, Philip T. Analysis of the eligibility of published economic evaluations for transfer to a given health care system. Methodological approach and application to the French health care system. Health Policy. 1999;49(3):161-177. doi:1016/s0168-8510(99)00057-3
  14. Greiner W, Schöffski O, von der Schulenburg JM. The transferability of international economic health-economic results to national study questions. Health Economics in Prevention and Care. 2000;1(2):94-102.
  15. Welte R, Feenstra T, Jager H, Leidl R. A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics. 2004;22(13):857-876. doi:2165/00019053-200422130-00004
  16. Sculpher MJ, Pang FS, Manca A, et al. Generalisability in economic evaluation studies in healthcare: a review and case studies. Health Technol Assess. 2004;8(49):1-192. doi:3310/hta8490
  17. Boulenger S, Nixon J, Drummond M, Ulmann P, Rice S, de Pouvourville G. Can economic evaluations be made more transferable? Eur J Health Econ. 2005;6(4):334-346. doi:1007/s10198-005-0322-1
  18. Drummond M, Manca A, Sculpher M. Increasing the generalizability of economic evaluations: recommendations for the design, analysis, and reporting of studies. Int J Technol Assess Health Care. 2005;21(2):165-171.
  19. Urdahl H, Manca A, Sculpher MJ. Assessing generalisability in model-based economic evaluation studies: a structured review in osteoporosis. Pharmacoeconomics. 2006;24(12):1181-1197. doi:2165/00019053-200624120-00004
  20. Manca A, Willan AR. 'Lost in translation': accounting for between-country differences in the analysis of multinational cost-effectiveness data. Pharmacoeconomics. 2006;24(11):1101-1119. doi:2165/00019053-200624110-00007
  21. Nixon J, Rice S, Drummond M, Boulenger S, Ulmann P, de Pouvourville G. Guidelines for completing the EURONHEED transferability information checklists. Eur J Health Econ. 2009;10(2):157-165. doi:1007/s10198-008-0115-4
  22. Drummond M, Barbieri M, Cook J, et al. Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. Value Health. 2009;12(4):409-418. doi:1111/j.1524-4733.2008.00489.x
  23. Antonanzas F, Rodríguez-Ibeas R, Juárez C, Hutter F, Lorente R, Pinillos M. Transferability indices for health economic evaluations: methods and applications. Health Econ. 2009;18(6):629-643. doi:1002/hec.1397
  24. Chase D, Rosten C, Turner S, Hicks N, Milne R. Development of a toolkit and glossary to aid in the adaptation of health technology assessment (HTA) reports for use in different contexts. Health Technol Assess. 2009;13(59):1-142. doi:3310/hta13590
  25. Turner S, Chase DL, Milne R, et al. The adaptation of health technology assessment reports: identification of the need for, and development of, a toolkit to aid the process. Int J Technol Assess Health Care. 2009;25 Suppl 2:28-36. doi:1017/s0266462309990651
  26. Daniel Mullins C, Onwudiwe NC, Branco de Araújo GT, et al. Guidance document: global pharmacoeconomic model adaption strategies. Value Health Reg Issues. 2014;5:7-13. doi:1016/j.vhri.2014.02.006
  27. Wilkinson T, Chalkidou K, Walker D. Bill and Melinda Gates Foundation Methods for Economic Evaluation Project (MEEP). NICE International; 2014.
  28. Kim DD, Bacon RL, Neumann PJ. Assessing the transferability of economic evaluations: a decision framework. In: Wanrudee Isaranuwatchai W, Archer RA, Teerawattananon Y, Culyer AJ, eds. Non-Communicable Disease Prevention: Best Buys, Wasted Buys and Contestable Buys. Open Book Publishers; 2019. https://books.openbookpublishers.com/10.11647/obp.0195/ch6.xhtml.

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History

  • Receive Date: 28 July 2023
  • Revise Date: 20 April 2024
  • Accept Date: 20 August 2024
  • First Publish Date: 21 August 2024

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