HEALTH TEACHNOLOGY -a health technology refers to HTA STEPS

the application of organized knowledge and skills in

the form of devices, medicines, vaccines, procedures
and systems developed to solve a health problem and
improve quality of lives. Health technologies include
pharmaceuticals, devices, procedures and
organizational systems used in health care.
Health Technology Assessment -is a systematic
evaluation of properties, effects, or impact of health-
related technologies, devices, medicines, vaccines,
procedures, and all other health-related systems
developed to solve a health problem and improve the
quality of life and health outcomes, utilizing a
multidisciplinary process to evaluate the clinical,
economic, organizational, social, and ethical issues of
a health intervention or health technology.
What is the legal and policy framework of HTA in the
Philippines?
*RA 11223: Universal Healthcare Act
institutionalized HTA as a fair and transparent priority
setting mechanism that shall be recommendatory to
the DOH and PhilHealth for the development of
policies, programs, regulations, and the determination
of a range of entitlements such as drugs, medicines,
pharmaceutical products, other devices, procedures,
and services.
*RA 10606: National Health Insurance Act of 2013
mandated the utilization of HTA in guiding
PhilHealth's coverage of health services.
1. Topic nomination -refers to the process of referring
topics to HTAC for which technology appraisals may
be produced and disseminated for the guidance of
policymakers, health providers and patients.
2. Topic Prioritization -refers to the process of
evaluating first the based on urgency of need and
population
3. Scoping and Protocol Development -aims to
systematically search, identify and map different
understandings of complex interventions. It also
proposes to map and synthesize the approaches used
in health technology assessment to evaluate complex
interventions.
4. Topic Assessment -collation and critical review of
scientific evidence
5. Evidence Appraisal -(usually a systematic review)
on the impact of a healthcare intervention (or
'technology), often including economic evaluation
evidence as in the case of the National Institute of
Health and Clinical Excellence (NICE).
6. Recommendation- list of possible outcomes
7. Resolution- the outcome
8. Decision- implementation of the recommendation
9. Dissemination

*AO 2016-0034: The New Implementing Guidelines

of the Philippine National Formulary System (PNFS)
required that any medicine considered for inclusion in
the PNF shall be assessed its benefit-risk assessment
(safety and efficacy), cost- effectiveness, affordability
and public health relevance.

*AO 2018-0026: Framework for the Use of HTA to

Guide Coverage Decisions in Support of UHC
provided an explicit framework for a systematic and
consistent use of HTA to guide health coverage
decisions of both the DOH and PhilHealth.

*AO 2020-0041 "The New Implementing Guidelines

on Health Technology Assessment
to Guide Funding Allocation and Coverage Decisions in
support of Universal Health Care"
What is the purpose of this document?
The purpose of this document is to provide
mandatory guidance to researchers in conducting HTA
based on the prioritized topics and producing a
standardized HTA report that will be used to inform all
public funding, coverage, and resource reallocation/
optimization decisions made by the DOH and
PhilHealth.
Specific objectives:
1. To provide clear guidelines to researchers on
methodological standards in evaluating the clinical
and economic value of health technologies
What is the process of development of this
document?
 Review of literature based on publicly-available
resources from major HTA agencies and HTA
Networks (EunetHTA, INAHTA)
 Review of local HTA and HTA-related reports to
identify methodological weaknesses and address
them in this document
 Identification of gaps in the current HTA methods
in the Philippines in consultation with clinical,
health economics, and methods experts

2.. To ensure the consistency of methods and

 Round table discussions and public consultation
reporting standards of researchers with stakeholders to ensure that the
3. To give guidance to health care professionals, methodological standards consider practical
patients, and the general public on the decision issues and limitations in the Philippines while
meeting the needs of HTAC and decision makers
framework of the HTAC and healthcare decision
makers
 Differences in views and methodological
What is the scope of this document?
variations were resolved through consensus with
HTA aim to produce a recommendation for healthcare appropriate stakeholders
decision makers on the use of the following heath
technologies:

 Medicines
 Vaccines
 Medical devices
 Medical and surgical procedures
 Screening procedures and diagnostics
 Promotive and preventive health interventions
 Traditional and complementary medicine
 Other health interventions and technologies such
as system, organizations, delivery system of care

Who is the target audience of this document?

The target audience of this document are researchers

aiming to produce an HTA report, whether they are
internal or external to the DOH and PhilHealth. This
also serves as guide to the HTA Council and decision-
makers on the methodological standards that are
required in HTA to inform their recommendations and
decisions.

Key stakeholders:

 National DOH program managers

 Health authorities from municipal, city, and
provincial health governments
 Healthcare providers
 Healthcare organizations.
 Patient organizations
 How will this document be updated?

Initial PICOT

Scoping

Final PICOT

Protocol
Development

Clinical Assessment

Superior Non-inferior Inferior

Economic assessment
Ethical, Legal, Social Health technology will
(Cost-effectiveness
and Health System not be recommended
Analysis +budget
implications Analysis by HTAC
Impact analysis)

Economic assessment
Ethical, Legal, Social
(Cost-minimization
and Health System
Analysis +budget
implications Analysis
Impact analysis)

Conducting questions:

1. Research questions, in Population-Intervention- 4. Economic evaluations shall include both a CEA or a

Comparator- Outcome-Timeframe (PICOT) format,
shall be formulated from topics nominated by topic
sponsors and subsequently prioritized by the HTA
Core Committee.
2. For all prioritized topics, a study protocol for clinical
assessment stating the research questions, objectives,
and methods shall be developed by the assessment
team composed of technical researchers, a clinical
expert, and an information specialist.
3. Cost-effectiveness analysis (CEA) shall be conducted
for health technologies that exhibit significant and
meaningful clinical outcomes compared to the
comparator. For health technologies which exhibit
non-inferior or comparable clinical benefits versus the
comparator, a cost-minimization analysis (CMA) shall
be conducted.
CMA and a budget impact analysis (BIA) to assess
both the value for money of a health technology and
its affordability or the feasibility of publicly funding
the health technology relative to the Philippine
context.
5. All HTA Reports should be contextualized for the
Philippines and must include the analysis of ethical,
legal, social, and organizational and health system
implications when so necessary to facilitate the
understanding of various factors, issues, and barriers
relative the adoption of health technologies from the
local perspective. This may include consideration of
relevant national and international laws and policies
that may influence the uptake of the health
technology in both the national and local settings.