cadth 2015 a2 cadth international farup
TRANSCRIPT
HTA & Medical Devices:An InternationalPerspective
Christina Farup, MD, MS | April 2015
Definition of HTA Health Technology Assessment...
is a multidisciplinary process that summarises information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value
EUnetHTA: http://www.eunethta.eu/about-us/faq#t287n73
Key Considerations-What is the purpose of the HTA? How are devices reimbursed?-Are all devices alike and should be they treated as all the same or like drugs?-Who can best evaluate and translate the value of a device in the healthcare system and
delivery of care?-When and how should evidence evolve for devices?
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Class III
Class IIb
Class IIa
Class I
European HTA - 2000
European INAHTA members 2000
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European HTA – 2013
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Adelaide Health Technology Assessment (AHTA), Australia
Medical Services Advisory Committee (MSAC), Australia, since 1998
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), Australia
Australia and New Zealand Horizon Scanning Network (ANZHSN), Australia
AUSTRALIA
NEW ZEALAND
New Zealand Health Technology Assessment (NZHTA), New Zealand, since 1997
PHILIPPINES
HTA Committee of the PhilHealth, Philippines, since 1999
JAPAN
Department of Preventive Medicine, University of Tokushima, Japan
SOUTH KOREA
National Evidence-based Healthcare Collaborating Agency, South Korea
HTA Key Lab of MOH, WHO Collaboration Center (Fudan University)
HTA Division, Health Policy Development & Research Center of MOH
HTA Division, HTA Research Office of China Medical Academy
Pharmacoeconimics Centers: Peking University, Fudan University, Pharmaceutical Association
CHINA
HONG KONG
Office of Technology Management, Hong Kong, since
TAIWAN
CDE Center for Drug Evaluation, Taiwan, since 2007
THAILAND
National Health Security Office, Thailand, since 2002
SINGAPORE
Clinical Standards and Technology Assessment (CSTA) branch at the Singapore Ministry of Health, Singapore
INDONESIA
Center for Health Services Research and Development, Indonesia,
MALAYSIA
Kementerian Kesihatan Malaysia (KKM), Malaysia
Introduction to HEMA, Asia Pacific, August 2011
HTA in Asia Pacific
Product Advocacy
Cost-Benefit Analysis
Oversight
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• Submit requests for new products• Assemble available clinical and financial data• Provide subject-matter expertise and opinion of
products’ clinical benefits
Hospital Level• Review all available
clinical and cost data• Preform CER using
hospital-specific data• Recommends
approval or denial of request
System Level• Collect available data • Preform CER• Negotiate vendor and
GPO contracts
Hospital & System Level• Assess strategic
benefit to department, hospital, or system
• Prioritize hospital and system investments
• Set cost reduction & containment targets for materials management
Surgeon
OR Clinicians
Surgical Services Director
Finance Director
Materials Management Director COO
CFO
Chief of Surgery
Supply Chain Director
HTA in US= Hospital Value Assessment Committee
US VACs weigh the clinical, financial, and strategic benefits of new surgical products and services against the cost of adoption
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Clinical• Safety/quality• Patient discharge status• Outcomes• Decreased recovery time
Financial
• Decreased OR time• Decreased LoS• Increased efficiency
Strategic• Patient engagement• Payer relationships• Business model • Nurse/Staff satisfaction
Price differential with current solution• Product cost• Synergies with current product
portfolio and contracts• Historical cost benchmarks• Payer rates
Costs associated with adoption• Administrative • Training • Integration
Linkage to Quality MetricsInfectionPatient SatisfactionReadmissions
Bene
fits
Costs
Some “Take-away” thoughtsThe future potential to improve best practice
Aspects of device value are varied– HTA assessment of value– Hospital assessment of value– Limitations to both
New solutions for evidence development-affordable, practical, flexible when appropriate
More debate on when, who, why for HTA=“fit for purpose”-more dialogue with key stakeholders: Surgeons, Providers, Industry, Patients