HTA workshop:

Introduction to
Health Technology Assessment

ดร.ภญ.ศิตาพร ยังคง
คณะเภสัชศาสตร์ มหาวิทยาลัยมหิดล
3 พฤษภาคม 2560
 Faculty of Pharmacy
Mahidol University

Outline
 Why do we need HTA?

 What is HTA?

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Mahidol University

What are health technologies?

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Mahidol University

??????????
ตัวอย่างคาถาม
• ยาตัวนี้ปลอดภัยไหม มีประสิทธิภาพแค่ไหน?
• ภาครัฐควรจัดบริการสร้างเสริมสุขภาพใดให้กับ
ประชาชน?
• ควรให้วัคซีน xxx กับประชาชนกลุ่มใดบ้าง? อย่างไร?
• โรงพยาบาลควรเลือกยาตัวไหนเข้าบัญชียาของ
โรงพยาบาล?
• การคัดกรองโรค xxx ให้เกิดประสิทธิภาพ ควรมี
มาตรการอื่นๆ ร่วมด้วยหรือไม่ อย่างไร?
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Mahidol University

It is not always the case that

more money brings a better ‘health’

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Mahidol University

Evidence-informed decision making

 Priority setting has a dynamic nature

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Mahidol University

Rational decision making

Ad-hoc Rational
priority setting priority setting
Decision-maker Decision-maker

Ease of implementation
Economic growth
Severity of disease
Cost-effectiveness
Budget impact
Vulnerable populations
Burden of disease
Political issues Average population health

Evidence

Baltussen, R. and L. Niessen, Priority setting of health interventions: the need for multi-criteria decision analysis. Cost 7
Effectiveness and Resource Allocation, 2006. 4: p. 14.
 Faculty of Pharmacy
Mahidol University

What is Health Technology Assessment?

a structured analysis of a health technology, a set of related
technologies or a technology-related issue that is performed for the
purpose of providing input to a policy decision (Goodman 2004).

Technology Assessment

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Mahidol University

Why should low- & middle-income countries use HTA?

 HTA contributes to get good health technologies to
populations in LMICs
 HTA is a pragmatic, highly adaptable to improve decision-
makings
 HTA is not only about technical aspect but also process to
ensure a fair process of priority setting
 HTA guides and supports implementation
 HTA improves governance and strengthens health systems
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 Faculty of Pharmacy
Mahidol University

Concerns when using health technology

 Safety
 Efficacy/Effectiveness (benefits)
 Value for money (cost-effectiveness)
 Social & Ethical

The fourth hurdle

1
0
 Layers of questions & Layers of evidence

How should we do it

Health technology assessment

here?
Implementation

Should we do it
Appropriateness
here?

Can it work Effectiveness

here?
Efficacy

Regulation
Can it work?
Technical
Performance

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Mahidol University

Context is essential for evidence-informed

decision making
There are decisions that…

take good in context

… and use it well
evidence …

poor evidence … … and use it poorly

without context

Adapted from Shaxson, L 2004: Evidence-based policy making: if it exists what makes it robust? Available at http://bit.ly/hIsNC 12
 Faculty of Pharmacy
Mahidol University

Thai Health Technology Assessment guidelines

 There have been two editions of the HTA guidelines used as the
methodological references when conducting Health Technology
Assessment (HTA) studies in Thailand

The 1st issue (2008) The 2nd issue (2013)

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Mahidol University

Stakeholder involvement
Dissemination of results and recommendations
Publication, presentation and dialogues
HITAP, funding agencies, the media, consumer groups and other NGOs

Conducting HTA research

Consultation and technical Appraisal of results
collaboration Peer review, submission
of comments and
HITAP, experts and
relevant stakeholders discussion
HITAP, experts, private
business/industry,
policy makers,
Topic Selection consumers/beneficiaries
Consultation
HITAP, policy makers, healthcare providers,
consumer groups, professional associations, etc.

Sources: HTA process at HITAP 15

 Faculty of Pharmacy
Mahidol University

Countries with HTA agencies & part of INHATA

INAHTA (International Network of Agencies for Health Technology Assessment) a non-profit organization
was established in 1993 and has now grown to 52 member agencies from 29 countries
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