case report from asia – covid-19 pandemic and hta in taiwan
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Case Report from Asia –Covid-19 pandemic and HTA in
Taiwan
Raoh-Fang Jasmine PwuDirector, Taiwan NHCP Office, MOHW, Taiwan
Board of Director (2018-2021), ISPOR
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Our latest statistics
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(Feb 28, 2021)
https://sites.google.com/cdc.gov.tw/2019-ncov/taiwan
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⚫Confirmed case – 4 per 100,000 population
⚫Mortality – 0.04 per 100,000 population
⚫Case fatality rate – 0.97%
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https://journals.lww.com/jcma/Fulltext/2020/07000/Taiwan_s_experience_in_pandemic_control__Drawing.2.aspx
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https://time.com/5826025/taiwan-who-trump-coronavirus-covid19/
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https://asia.nikkei.com/Spotlight/Coronavirus/Taiwan-s-battle-against-coronavirus-began-in-late-2019
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Adapted from news press presentation MOHW, Feb 9, 2021
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Some key control measures
•Central Epidemic Command Center (CECC)
Operational Structure
•Communicable Disease Control Act
Legislation
•surveillance and laboratory diagnosis
•border control
•control of community transmission
• medical system response and preparedness
•stockpile and allocation of Personal Protective Equipment (PPE) and other medical supplies
•health education and disinformation management
Prevention Strategies
https://www.cdc.gov.tw/en/category/page/0vq8rsAob_9HCi5GQ5jH1Q
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Adapted from news press presentation MOHW, Feb 9, 2021
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Communicating with science
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HTA
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Cycle of decision making
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HTA and management
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Assessment- Comparative effectiveness- Cost-effectiveness
Appraisal- Scientific value judgement- Social value judgement
Decision- Responsibility / liability
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Definition (May 2020)
Health Technology Assessment (HTA) is defined as:
Health technology assessment is a
multidisciplinary process that uses explicit
methods to determine the value of a health
technology at different points in its lifecycle. The
purpose is to inform decision-making in order to
promote an equitable, efficient, and high-quality
health.
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INAHTA http://htaglossary.net/health+technology+assessment
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Healthcare spending is subject to ‘Distributive justice’
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https://slideplayer.com/slide/15201727/
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Procedural Justice
⚫ Whatever we define ‘distributive justice’, we can always try to meet ‘procedural justice’ first.
⚫ 「讓程序上符合參與式的民主,讓決策的資訊透明,讓利害關係人可以發聲,讓分配的標準與基礎可以得到充分的討論或修正,然後在審議的過程中形成共識,而此一有共識的決定本身,就是一個符合『正義』的決定」
Participation Transparency Voice of all stakeholders heard Base/standard of distribution fully discussed Consensus met through deliberative process
This is a ‘just’ decision
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Canada pERCDeliberative Framework for oncology drugs decision
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The 4 key areas
Clinical evidence
Patient values
Feasibility of Adoption
(into the Health System)
Cost-effectiveness
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US:Proposed elements of value
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Garrison, L.P.; Towse, A. Value-Based Pricing and Reimbursement in Personalised Healthcare: Introduction to the Basic Health Economics. J. Pers. Med. 2017, 7, 10.http://www.mdpi.com/2075-4426/7/3/10
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Recommendations for Making Outcome-based Payments a Reality in the NHS: An Application to Cancer Drugs – OHE
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COVID-related policy decision
⚫Many kinds of decisions School, border controls,….
⚫Public concerns Request clear information
Professionals and laymen’s critics
⚫Scientific, logic, reasoning is needed
⚫Data, interpretation, value judgement… very essential
⚫HTA mindset, mechanism and methodology can help
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