1 Sophie Werko International Relation Manager at Swedish Agency for HTA and Assessment of Social Services Adham Ismail Team Leader Essential Medicine and Health Technologies WHOEMRO ID: 748700
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Slide1
Health Technology Assessment for Universal Health Coverage
1
Sophie
Werko, International Relation Manager at Swedish Agency for HTA and Assessment of Social Services; Adham Ismail,Team Leader, Essential Medicine and Health Technologies, WHO/EMRO; and Mouna Jameleddine, Director of HTA Department at National Authority for Assessment and Accreditation,Tunisia
Results of Policy BriefSlide2
Objectives
To present briefly relevant information that can help in better understanding regional HTA situation , need, and relevant policiesTo suggest possible policy
options to support HTASlide3
Global Commitment
“A time to urgently and significantly scale up efforts to accelerate transition towards Universal Access and availability to affordable and quality healthcare services in line with SDGs”Achieving UHC includes
access to safe ,effective and affordable essential medicines and vaccines for allSlide4
What is HTA?
M
ultidisciplinary process
to evaluate the clinical, social, economic, organizational and ethical issues of a health intervention or health technology in a systematic, transparent, unbiased and robust manner Decision making and priority setting for:Buying – benefit package – public health programs – health interventions – procurement – pricing of medicines To increase value for money from scarce public resources and help to control medical expenditures Slide5
Need for HTAMost HICs now require HTA as part of their decision making processes
HTA is developing at an uneven rate across countries, role differs from one country to the otherLimited resources of developing countries mandate rational decision making about investments of new and emerging technologies Slide6
Well over
50% of expenditure on Medicines, Vaccines & other Health Technologies is wasted due to one reason or the other.
Medicines, Vaccines & other Health Technologies consume approximately 20-60%* of health budget in LMICs.
* Source: Regulatory System Strengthening, WHA Documents, EB134/29, January 2014.Slide7
Types of decisions informed by HTA
Government agencies , parliaments
Regulatory approval, reimbursement, public health programs, research funding
Health Care professionals
Adoption of technologies , practice guidelines
Hospital and other healthcare administrators
Equipment procurement, availability of procedures, service delivery
Private sector insurance
Scope and extent of coverage
Manufacturing Industry
Product development, marketing
Organization/Individual
Types of decisions informed Slide8
Types of decisions informed by HTA (Cont.)
,
>
>
Patient,
carers
and their representatives
Guidance for treatment and support access to services , shared decision making with health care professional
General public, citizens
Information for future decisions on healthcare
Legal professionals
Judges decisions after demands for the use of high cost healthcare technologies
Academia
Information for future healthcare professionals, decisions on research
Organization/Individual
Types of decisions informed Slide9
MENA –Regional Context
Economic
changes and budget constrains
Dynamic Political environment
Demographic transition and rise in NCDs
High
out of pocket expenditure
In
consistent quality of care Slide10
Regional Context Out of pocket expenditure levels are high reaching 64% in LMICs in HICs–(2014), 31% in UMICs and 13.5% in
HICs Government health spending is variable often limited
How to get best value for money spending?Slide11
Transition for Transformation Implementing complex
reformsFinding ways for sustainable financing of health systemsFinding ways of sustainable financing of population demands Slide12
Mapping of EMR HTA (2014):
Survey Results
52% indicated that they perform HTA or HTA-like activitiesMost activities were related to
clinical effectiveness and economic evaluations (67% and 62% respectively); The remaining 48% (not performing HTA-like activities)Over 50% do not know if there are future plans to develop HTA programmes in their national entities. Almost 75% indicated that using HTA in the decision-making process will be their biggest obstacle. Slide13
Prerequisites for successful implementation of HTA programs :
•
Political will and acceptance of HTA as an integrated system for routine evaluation of health
technologies• Strong financial commitment and support from governments to establish national HTA programmes• Adequate human resources and means of enhancing their HTA-related knowledge and skills• Presence of reliable health information systems that will be able to generate valid and accurate data.Slide14
HTA
HTA institutionalization pillars
Capacity building
Analysis
of
system needs
Networking
Involving key
stakeholders
Legal
and
technical framework
Political will
FundsSlide15
Challenges to HTA institutionalization
Misunderstanding of the role of HTA
Lack of political will
Traditional ways of governing Resistance to change Long time to establish HTA Lack of financial resources to perform HTA Lack of knowledge about evidence-based medicineLack of human resourcesC
onflicts
of
interest
L
ow
quality of data
Transparency issues
Slide16
Recommendations and
the way forward
Develop
an over-arching HTA policy to support policy decisions on health interventions and facilitate more rational use of resourcesCountries to carry out national HTA mapping surveysCountries to raise awareness of current HTA status and/or to advocate for adopting HTACountries should link HTA efforts to ongoing policy priorities and initiatives in the countryNational HTA units should start small regarding staffing and budget. C
ountries
should identify specific HTA areas where assistance is required, for example, training on the HTA process, literature surveys, format and production of HTA reports, etc.Slide17
The Role
of MENA HPF
Four areas have been identified in which MENA HPF can fulfill
an important role :1. Address national organizations of health reforms in different countries and assist them in drafting effective strategies, identify the important areas of research, including allocation of scarce health resources across competing interest groups2. Assess readiness of health systems3. Provide a venue for the exchange of experiences and for networking to help the achievement of universal health coverage 4. Together with WHO, MENA HPF should focus on building HTA capacity and on monitoring progress towards HTA. This could be done through the development of an agenda to support decision-making and the development of a framework of indicators for measurements. It would thus serve as a platform to generate evidence to help policy-making.Slide18
Thank you