HTA in Spain

Jaime Espin, PhD

Professor

Agenda

• Spanish Health System – General

Overview

• HTA process for decision making

• HTA agencies in Spain

• HTA & medicines (ambulatury and

hospital)

• (Some) conclusions

Spanish Health System

• 1986 – General Health Law established a National Health Service (NHS)

• Spain is a health care management decentralized system, with universal coverage and finance for general taxation

• 17 regions with competences in public health, healthcare services planning and full control budget

• Health care is provided free of charge, except for pharmaceuticals

Source: http://www.ispor.org/HTARoadMaps/Spain.asp

Source: Sampietro-Colom L1, Asua J, Briones E, Gol J; AuNETS Group. History of health technology assessment: Spain. Int J Technol Assess Health Care. 2009 Jul;25 Suppl

1:163-73. doi: 10.1017/S026646230909059X. Epub 2009 Jun 19.

Source: Kanavos P, Espin J, van der Aardweg S. Short - and long - term effects of value-based pricing vs. external price referencing. EMINET (2010 Jan)

HTA agencies in Spain

HTA agencies in Spain

Activities of HTA Agencies in Spain (%)

Source: Pérez Cañellas, Elena. Las Agencias de Evaluación de Tecnologías en España. Análisis de actividad y situación actual. Análisis de actividad y situación actual.

Tesina Master en Administración y Dirección de Servicios Sanitarios. 2011

Type of products

Products by HTA Agencies in Spain

Network of HTA Agencies in Spain

Medicines – A different history

P&R in Spain (II)

Source: PPRI

P&R in Spain (III)

Source: PPRI

Pricing - Procedure

Remark: In Spain the reimbursement decision precedes the price decision,

since only reimbursable products have a regulated price

Interministerial Commission

of Pharmaceutical Prices

Representatives from

Ministry of Health

Ministry of Finance

Ministry of Industry

Directorate General of

Pharmacy and Health

Products

P&R in Spain (IV)

Source: PPRI

Genesis Group – Hospital Pharmacist

(Some) Conclusions

• Several institutions (too many) made HTA

in Spain

• Lack of coordination (until now)

• High quality of the reports, but they are not

mandatory

• Financial crisis – need of avoid

overlapping in the activities

Thank you very much for your attention!!!

jaime@easp.es