HTAi Asia Policy Forum Briefing Papers: Value and Affordability, Transferability, and Delivery of High Quality HTA for Decision Making

The fourth annual meeting of the Health Technology Assessment International (HTAi) Asia Policy Forum (HAPF) was held in November 2016. The HAPF meetings are attended by participants from: HTA and payer systems in Asian countries; pharmaceutical and medical device companies with interest and expertise in Asia; invited experts; and the organisers, and are designed to promote in-depth, open and constructive exchange between these stakeholder groups.

The OHE worked with HTAi, Chris Henshall, and the global pharmaceutical industry to establish the AHPF in 2013. OHE’s Adrian Towse and Grace Hampson provided the scientific secretariat for the first four of these meetings 2013-2016, working in close collaboration with HTAi and Chris Henshall, Chair of the HAPF 2013-2016. The chair and scientific secretariat from 2017 will come from the Asia-Pacific region.

The background papers for each of the 2013-2016 meetings are now available. A brief summary of each is provided below:

2016

The topic of the 2016 meeting was: Assessing Value, Budget Impact and Affordability to Inform Discussions on Access and Reimbursement: Principles and Practice, with Special Reference to High Cost Technologies.

The background paper begins with a discussion of how value can be defined, measured and factored into decisions on access and coverage.

Next, the paper looks at how budget impact and affordability can be defined and measured: we explain how different countries have adopted different approaches to how and when budget impact has been included within the decision making process, and outline several different scenarios around affordability challenges.

The final section considers whether high cost interventions call for new approaches to assessment and/or reimbursement, drawing on the recent high profile example of Sovaldi for the treatment of Hepatitis C.

2015

The topic of the 2015 meeting was: How can HTA meet the needs of health system and government decision makers?

The background paper sets out the issues to be addressed in considering where and when HTA could be a useful aid for decision making, what HTA can be used to achieve, and where the evidence for HTA can be obtained from (including a brief recap of the transferability discussions in the 2014 meeting of the AHPF).

The final section considers how decision makers can combine all the relevant criteria and information to arrive at a decision; we discuss the spectrum of approaches from deliberative to more structured decision making processes including the use of Multi-Criteria Decision Analysis (MCDA).

Various different approaches to MCDA could be used to add structure and transparency to decision making processes, and pilots conducted in Asia have been reported favourably. MCDA has not, however, been widely adopted in health care decision making to date.

2014

The 2014 meeting looked at: Transferability of HTA.

HTA is a tool to support health systems to make decisions about allocating their limited health care resources. In turn, HTA needs to be efficient and effective if investment in HTA is to be a sensible use of money. One important part of ensuring this will be to avoid duplication of effort by making the best possible use of existing information, and ensuring that when resources devoted to HTA are generating new information, it is likely to be of sufficient value to justify its cost.

This background paper sets out the issues to be addressed in considering when health systems can benefit from the transfer of HTA processes, decisions and/or data. We discuss the different kinds of decisions that may or may not be transferred, the different degrees of transfer possible, and how decisions can be adapted to different contexts.

Overall, we conclude that some of the barriers to transferability may be lower than is generally believed.

2013

The topic of the 2013 meeting was: How can the available resources be used most effectively to deliver high quality HTA that can be used by health system decision makers?

The background paper begins by looking at the increasing interest in the use of HTA, how HTA has evolved, where HTA has got to in Asia.

The report then seeks to address the follow questions:

  • What information do decision makers need?
  • How can HTA best meet these information needs?
  • How can HTA and decision making best be linked?

The report also includes short appendices which provide an overview of the use of HTA in each of the health systems represented at the meeting: China, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand.

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