Valuing Medical Technologies

The Decision Maker Perspective

Historical Concerns with HTA

Traditional HTA takes too long (outdated before it is completed), technologies infiltrate the system before they are assessed

Delays policy decisions, impacting patient care

Insufficient Evidence – more research is almost always required

HTA capacity is inadequate to amount of new technologies developed

HTAs do not adequately address policy issues

Decision Making Environment Evidence based decision making

‘Common Sense’ vs Evidence Simple solutions to complex problems?

Celebrity Advocacy Individual Stories

Dr. Google: The internet as an information source

‘Truthiness’ in Twitter and other Social Media Studies indicate that patients tend to

overestimate the benefits and underestimate the risks of new treatments

Public perceptions of Government Sustainability

Challenges for Decision Makers Timeliness of HTAs (and decisions) Pressures

Providers Research / Innovation and Economic Development Advocacy groups Oprah Effect Media

Patient Centred – what matters to patients? Uncertainty

Safety: ‘Primum non nocere’ ?

Challenges Specific to Non-Drug Technologies Volume of medical devices Level of evidence Ethical concerns: rapid adoption vs long term evidence Product life cycle and long term evidence Lack of a Common Technology Review and/or

‘formularies’ technology infiltrating the system

Broader context and impacts of non-drug technologies (HR needs, training, credentialing, facility readiness)

Blended Costs Technology is transcending across historical categories

of Drugs, Non-Drugs and Information Technology Innovation Gap

The BC Health Technology Review Evidence informed decisions to ensure

citizens receive the best health care that the province can afford.

Health Technology Assessment Committee Multidisciplinary committee HSSBC, Public, Professional Members, MOH, and HA

MCDA framework for recommendations Joint HA and Ministry decision making Rapid Reviews Reassessment Policy