HTA - what is it about/ what for MTV – speciallægekursus i samfundsmedicin - and HTA in European context Finn Boerlum Kristensen, MD, PhD Chairman, European Network for HTA, EUnetHTA Executive Committee Director, EUnetHTA Coordinating Secretariat, National Board of Health Adjunct professor, University of Southern Denmark HTA presentation Zagreb, Croatia 20100119
W hat is HTA • Healthcare technology is defined as prevention and rehabilitation, vaccines, pharmaceuticals and devices, medical and surgical procedures, and the systems within which health is protected and maintained • Technology assessm ent in health care is a multidisciplinary field of policy analysis . It studies the medical, social, ethical, and economic implications of development, diffusion, and use of health technology INAHTA HTA presentation Zagreb, Croatia 20100119
Technology ”diffusion” Use of technology in health care Time line of innovation Obsolete? ? ? Experi- Investiga- Nearly established Established mental tional Basic Applied Technology research research HTA presentation Zagreb, Croatia 20100119
Acceleration / deceleration of technology ”diffusion” Use of technology in health care Time line of innovation Obsolete? ? ? Experi- Investiga- Nearly established Established mental tional Basic Applied Technology research research HTA presentation Zagreb, Croatia 20100119
Decision- Decision -making domain making domain Research domain Research domain including regulation including regulation Policy making HTA-paradigm paradigm HTA Summary Planning HTA- project of the /policy questions assessment question Based on Kristensen FB et al. Seminars in Colon and Rectal Surgery, 2002; 13: 96 – 103 HTA presentation Zagreb, Croatia 20100119
” The four boxes” - the Danish model Technology Patient � � Area of application Psychological � Effectiveness aspects � � Risk assessment Social aspects � Ethical aspects Organisation Econom y � � Structure Social and health � Staff economic appraisal � � Environment Operational economic appraisal HTA presentation Zagreb, Croatia 20100119
Policy-questions HTA-questions Organ- Techn- Eco- Patient Evidence, isation ology analysis nomy Synthesis HTA-report HTA presentation Zagreb, Croatia 20100119
Health problem and current use of technology Domains of HTA Technical characteristics Safety • Identified in previous EU Clinical effectiveness projects, particularly EUR-ASSESS and Costs and economic evaluation ECHTA/ECAHI Ethical analysis • Promote the wide scope and multidisciplinary nature Organisational aspects of HTA Social aspects Social aspects Legal aspects HTA presentation Zagreb, Croatia 20100119
DACEHTA HTA as an input to priority-setting and decision-making Priority-setting and decision-making HTA HTA presentation Zagreb, Croatia 20100119
DACEHTA HTA as an input to priority-setting and decision-making Advising, recommending Priority-setting and decision-making HTA HTA presentation Zagreb, Croatia 20100119
Joint Action A total of 33 government appointed organisations from 23 EU Member States and Norway and a large number of relevant non-for-profit organisations that produce or contribute to HTA HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
Strategic position • All activities of the EUnetHTA Collaboration arise from the premise that its outputs will be used to inform but not mandate the content of national / regional / institutional HTA reports HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
HTA definition • HTA is a multidisciplinary process that summarises information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner • Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value • Despite its policy goals, HTA must always be firmly rooted in research and the scientific method EUnetHTA HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
EUnetHTA Project 2006-08 64 Partners 55 Partners from 29 countries (21 EU Member States) including 9 International Partner Organisations • Final Technical Report published by DG SANCO on http://ec.europa.eu/health/ph_systems/docs/eunethta_report_en.pdf • Fourteen scientific articles now published in Int J Technol Assess Health Care, 2009: 25 (Suppl. 2) January 2010 HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment 20100119
What did we do differently? • Focus on methodology but ALSO on a working process (i.e. developing practical tools) • Orientation towards results and continuity • Strong emphasis on the management and organisational support structures for co-operation HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
What did we do differently? • Stakeholder involvement, openness to dialogue and inclusiveness • Attention to the policy processes in European healthcare • Continuous attention to delivering a unique and added value to partners and users HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
Health problem and current use of technology Domains of HTA Technical characteristics Safety • Identified in previous EU Clinical effectiveness projects, particularly EUR-ASSESS and Costs and economic evaluation ECHTA/ECAHI Ethical analysis • Promote the wide scope and multidisciplinary nature Organisational aspects of HTA Social aspects Social aspects Legal aspects HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
AE = assessment element The Core HTA Structure AE = Core element AE = Non-core element i.e. HTA Core Models and their applications INFO = Locally produced information that does not follow HTA Core model structure Pool of Structured HTA Information CORE HTA LOCAL REPORT H T A C o r e M o d e l s AE AE AE AE AE AE AE Domain 1 INFO AE AE AE AE AE AE AE AE AE INFO Domain 2 AE AE AE AE INFO AE AE AE AE AE AE AE AE Domain 3 AE AE AE AE AE Takes into account local AE AE AE Domain 4 epidemiology, Summary of key resources, AE AE findings values, etc. HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
EUnetHTA Collaboration 2008 + •Established by 25 Founding Partners from 15 countries (13 EU Member States, Norway, Switzerland) •The partnership will be expanded with HTA organisations from European countries that are government nominated •Relevant non-for-profit organisations that produce or contribute to HTA and will be actively involved and provide scientific input can become EUnetHTA Associates HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
Plenary Assembly (policy setting) reporting control EPSCO WG on Public Health Stakeholder Executive Committee (strategic Forum info planning of activities) info EMEA DG Ent WG Clinical control reporting Investigation and Evaluation Determine Secretariat coordination / activities exchange of info support/control reporting Work Work Work Work Work Work Package Package Package Package Package Package HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
EUnetHTA Joint Action 2010-2 •A total of 33 government appointed organisations from 23 EU Member States and Norway (”Associated Partners”) •Relevant non-for-profit organisations that produce or contribute to HTA and will be actively involved and provide scientific input (”Collaborating Partners”) HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment 20100119
EUnetHTA associated partners – Austria LBI-HTA, Ludwig Boltzman Institute, HTA – Austria HVB, Hauptverband der Österreichischen Sozialversicherungsträger(Association of Austrian Social Insurance Institutions) – Austria GÖG-Gesundheit Österreich GmbH/Geschäftsbereich BIQG- Bundesinstitut für Qualität im Gesundheitswesen – Belgium KCE, Belgian Health Care Knowledge Centre HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
EUnetHTA associated partners – Bulgaria National Center of Public Health Protection – Czech Republic Ministry of Health – Denmark NBoH, National Board of Health – Denmark SDU, Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark – Estonia UTA, Department of Public Health, University of Tartu HTA presentation Zagreb, Croatia EUnetHTA | European network for Health Technology Assessment | www.eunethta.net 20100119
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