International Journal of Technology Assessment in Health Care最新文献

{"title":"Development of an MCDA Framework for Rare Disease Reimbursement Prioritization in Malaysia.","authors":"Ku Nurhasni Ku Abd Rahim, Nurkhodrulnada Muhamad Lattepi, Roza Sarimin, Foo Sze Shir, Syaqirah Akmal, Lee Sit Wai, Izzuna Mudla Mohamed Ghazali","doi":"10.1017/S026646232400031X","DOIUrl":"https://doi.org/10.1017/S026646232400031X","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of patient organizations' involvement in medicine appraisal and reimbursement processes in Finland - a qualitative study.","authors":"Mirjami Tran Minh, Marja Airaksinen, Tuuli Lahti","doi":"10.1017/S0266462324000229","DOIUrl":"https://doi.org/10.1017/S0266462324000229","url":null,"abstract":"<p><strong>Background: </strong>This study investigated how patient representatives have experienced their involvement in medicines appraisal and reimbursement processes with the Council for Choices in Health Care in Finland (COHERE) and the Pharmaceuticals Pricing Board (PPB) and how authorities perceive the role of patient organizations' input.</p><p><strong>Methods: </strong>Semi-structured thematic individual and pair interviews were conducted in 2021 with representatives (n = 14) of patient organizations and government officials (n = 7) of the Ministry of Social Affairs and Health. The interview data were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>Patient representatives expressed their appreciation for the PPB and the COHERE in creating consultation processes and systematic models that support involvement. However, there were many challenges: patient representatives were uncertain about how their submissions were utilized in official processes and whether their opinions had any significance in decision-making. Patients or patient organizations lack representation in appraisal and decision-making bodies, and patient representatives felt that decision-making lacked transparency. The importance of patient involvement was highlighted by the authorities, but they also emphasized that the patient organizations' contributions were complementary to the other materials. Submissions regarding the medications used to treat rare diseases and those with limited research evidence were considered particularly valuable. However, the submissions may not necessarily have a direct impact on decisions.</p><p><strong>Conclusions: </strong>The interviews provided relevant input for the development of involvement processes at the PPB and COHERE. The interviews confirmed the need for increased transparency in the medicines assessment, appraisal, and decision-making procedures in Finland.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PP78 Real-World Trends And Medical Costs Of Stroke After Transcatheter Aortic Valve Implantation In Korea: A Nationwide, Population-Based Study","authors":"Sujin Jung, Hyewon Nam, Schezn Lim, Jae H. Choi","doi":"10.1017/s0266462324000126","DOIUrl":"https://doi.org/10.1017/s0266462324000126","url":null,"abstract":"\u0000 \u0000 Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis. While procedural advancements have reduced the risk of stroke, stroke remains a serious complication of TAVI. To date, no study has investigated post-TAVI stroke costs in Korea. This study compared medical costs between patients with and without stroke after TAVI.\u0000 \u0000 \u0000 \u0000 This was a retrospective study using claims data from the Korean Health Insurance Review and Assessment Service. Patients who underwent TAVI in certified hospitals between June 2015 and December 2020 were included; patients with SAVR prior to TAVI were excluded. Patients with postoperative stroke within 30 days of TAVI formed the “Stroke” group; remaining patients formed the “Non-Stroke” group. A generalized linear model with adjustment was used to compare mean medical costs in the first year after TAVI between the two groups. Exchange rate from xe.com (5 December 2022) was applied.\u0000 \u0000 \u0000 \u0000 In total, 3,046 TAVI patients were included for analysis (47% male, 85% aged ≥ 75 years). There were 61 (2%) patients in the “Stroke” group and 2,985 (98%) in the “Non-Stroke” group. Compared to the “Non-Stroke” group, the “Stroke” group had significantly higher adjusted mean total first-year medical costs (KRW 25,453,725 (95% confidence interval (CI):15,215,439-42,581,231) (USD 19,640 (95% CI:11,740-32,856)) vs. KRW 19,169,447 (95% CI:11,818,973-31,091,340) (USD 14,791 (95% CI:9,120-23,990)), p < 0.01). Of these costs, 90 percent (“Stroke”) and 84 percent (“Non-Stroke”) were hospitalization-related (“Stroke” vs. “Non-Stroke”: KRW 6,847,975 (USD 5,284); p < 0.01); the remainder were outpatient costs. Predictors of total medical costs were gender; hospital type; prior chronic obstructive pulmonary disease; prior diabetes; prior stroke; and postoperative stroke.\u0000 \u0000 \u0000 \u0000 In Korea, TAVI patients with stroke had higher first-year medical costs compared to those without stroke, driven by hospitalization costs. Stroke poses an immediate, heavy economic burden on healthcare systems. Longer-term (e.g., caregiver, rehabilitation) costs were not captured in this analysis; future studies are needed to provide supplementary evidence on the total economic burden of stroke.\u0000","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can requests for real-world evidence by the French HTA body be planned? An exhaustive retrospective case-control study of medicinal products appraisals from 2016 to 2021.","authors":"Judith Fernandez, Céleste Babin, Camille Thomassin, Floriane Pelon, Sophie Kelley, Pierre Cochat, Margaret Galbraith, Driss Berdaï, Antoine Pariente, Francesco Salvo, Antoine Vanier","doi":"10.1017/S0266462324000291","DOIUrl":"10.1017/S0266462324000291","url":null,"abstract":"<p><strong>Objectives: </strong>In France, decisions for pricing and reimbursement for medicinal products are based on appraisals performed by the National authority for health (<i>Haute Autorité de Santé</i> (HAS)). During the appraisal process, additional real-world evidence can be requested as \"Post-Registration Studies\" (PRS) when there are uncertainties in evidence that could be resolved by additional data collection. To facilitate PRS planning, a retrospective exploratory analysis was conducted to identify the characteristics of medicinal products associated with a PRS request.</p><p><strong>Methods: </strong>This analysis encompassed all appraisals finalized between January 1, 2016 and December 31, 2021 and compared products for which the appraisal led to a PRS request with those that did not.</p><p><strong>Results: </strong>Six hundred positive opinions for reimbursement were identified, with a PRS request present in 17 percent (n = 103) of cases. The independent characteristics associated with a PRS request were a mild or moderate clinical benefit score, a major to moderate or minor clinical added value score, previous availability under an early access program, and certain therapeutic areas (neurology, pulmonology, and endocrinology). These findings suggest two different profiles of PRS requests: (i) products for which there is uncertainty in the size of the clinical benefit and (ii) innovative products for which a substantial benefit is expected but uncertainties persist.</p><p><strong>Conclusions: </strong>These results will assist health technology developers to better anticipate data generation to promptly address uncertainties identified by HAS. It may also help HAS and other assessment agencies to work together to improve postlaunch evidence generation according to the characteristics of the medicinal products.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the cost and cost-effectiveness of immunoglobulin treatment in patients with hematological malignancies.","authors":"Sara Carrillo de Albornoz, Khai Li Chai, Alisa M Higgins, Dennis Petrie, Erica M Wood, Zoe K McQuilten","doi":"10.1017/S026646232400028X","DOIUrl":"10.1017/S026646232400028X","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with hematological malignancies are likely to develop hypogammaglobulinemia. Immunoglobulin (Ig) is commonly given to prevent infections, but its overall costs and cost-effectiveness are unknown.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA guidelines to assess the evidence on the costs and cost-effectiveness of Ig, administered intravenously (IVIg) or subcutaneously (SCIg), in adults with hematological malignancies.</p><p><strong>Results: </strong>Six studies met the inclusion criteria, and only two economic evaluations were identified; one cost-utility analysis (CUA) of IVIg versus no Ig, and another comparing IVIg with SCIg. The quality of the evidence was low. Compared to no treatment, Ig reduced hospitalization rates. One study reported no significant change in hospitalizations following a program to reduce IVIg use, and an observational study comparing IVIg with SCIg suggested that there were more hospitalizations with SCIg but lower overall costs per patient. The CUA comparing IVIg versus no Ig suggested that IVIg treatment was not cost-effective, and the other CUA comparing IVIg to SCIg found that home-based SCIg was more cost-effective than IVIg, but both studies had serious limitations.</p><p><strong>Conclusions: </strong>Our review highlighted key gaps in the literature: the cost-effectiveness of Ig in patients with hematological malignancies is very uncertain. Despite increasing Ig use worldwide, there are limited data regarding the total direct and indirect costs of treatment, and the optimal use of Ig and downstream implications for healthcare resource use and costs remain unclear. Given the paucity of evidence on the costs and cost-effectiveness of Ig treatment in this population, further health economic research is warranted.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An operationalization framework for lifecycle HTA.","authors":"Franz B Pichler, Meindert Boysen, Nicole Mittmann, Ramiro Gilardino, Andrew Bruce, Ken Bond, Rick A Vreman, Nathalie Largeron, Judit Banhazi, Daniel A Ollendorf, Mohit Jain, Sheela Upadhyaya, Wim G Goettsch","doi":"10.1017/S0266462324000199","DOIUrl":"https://doi.org/10.1017/S0266462324000199","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deliberative process of health technology reassessment by health technology assessment agency in Korea.","authors":"Sangjin Shin, Yunjung Kim, Jieun Choi, Jung Yul Park","doi":"10.1017/S026646232400014X","DOIUrl":"10.1017/S026646232400014X","url":null,"abstract":"<p><p>In 2019, the National Evidence-based Healthcare Collaborating Agency (NECA) in Korea established a health technology reassessment (HTR) system to manage the life cycle of health technologies and develop operational measures promoting the efficient use of healthcare resources. The purpose of this study is to introduce the detailed implementation process and practical functional methods of the HTR implemented by NECA.The HTR is a structured multidisciplinary method for analyzing health technologies currently used in the healthcare system based on the latest information on parameters, such as clinical safety, effectiveness, and cost-effectiveness of optimizing the use of healthcare resources as well as social and ethical issues. All decision-making stages of the HTR are carefully reviewed and transparently managed. The HTR committee makes significant decisions, and the subcommittee decides the details related to the assessment process.Since the pilot began in 2018, 262 cases have been reassessed, of which, 126 cases (48.1 percent) were health services not covered by the National Health Insurance (NHI). Over the past 5 years, approximately 130 recommendations for the in-use technologies were determined by the HTR committee. In the near future, it will be necessary to officially develop and establish a Korean HTR system and a legal foundation to optimize the NHI system.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on the appropriate discounting rates for the economic evaluation of gene therapies: whether a specific approach is justified to tackle the challenges?","authors":"Tingting Qiu, Samuel Aballéa, Michal Pochopień, Mondher Toumi, Claude Dussart, Dan Yan","doi":"10.1017/S0266462324000096","DOIUrl":"10.1017/S0266462324000096","url":null,"abstract":"<p><strong>Objectives: </strong>Discounting the cost and effect for health intervention is a controversial topic over the last two decades. In particular, the cost-effectiveness of gene therapies is especially sensitive to the discount rate because of the substantial delay between the upfront cost incurred and long-lasing clinical benefits received. This study aims to investigate the influence of employing alternative discount rates on the incremental cost-effectiveness ratio (ICER) of gene therapies.</p><p><strong>Methods: </strong>A systematic review was conducted to include health economic evaluations of gene therapies that were published until April 2023.</p><p><strong>Results: </strong>Sensitivity or scenario analysis indicated that discount rate represented one of the most influential factors for the ICERs of gene therapies. Discount rate for cost and benefit was positively correlated with the cost-effectiveness of gene therapies, that is, a lower discount rate significantly improves the ICERs. The alternative discount rate employed in some cases could be powerful to alter the conclusion on whether gene therapies are cost-effective and acceptable for reimbursement.</p><p><strong>Conclusions: </strong>Although discount rate will have substantial influence on the ICERs of gene therapies, there lacks solid evidence to justify a different discounting rule for gene therapies. However, it is proposed that the discount rate in the reference case should be updated to reflect the real-time preference, which in turn will affect the ICERs and reimbursement of gene therapies more profoundly than conventional therapies.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health technology assessment and healthcare environmental sustainability: Prioritizing effort and maximizing impact.","authors":"Martin Hensher","doi":"10.1017/S0266462324000230","DOIUrl":"https://doi.org/10.1017/S0266462324000230","url":null,"abstract":"<p><p>The growing global focus on and sense of urgency toward improving healthcare environmental sustainability and moving to low-carbon and resilient healthcare systems is increasingly mirrored in discussions of the role of health technology assessment (HTA). This <i>Perspective</i> considers how HTA can most effectively contribute to these goals and where other policy tools may be more effective in driving sustainability, especially given the highly limited pool of resources available to conduct environmental assessments within HTA. It suggests that HTA might most productively focus on assessing those technologies that have intrinsic characteristics which may cause specific environmental harms or vulnerabilities, while the generic environmental impacts of most other products may be better addressed through other policy and regulatory mechanisms.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifecycle HTA: Promising applications and a framework for implementation.","authors":"Franz B Pichler, Meindert Boysen, Nicole Mittmann, Ramiro Gilardino, Andrew Bruce, Ken Bond, Rick A Vreman, Nathalie Largeron, Judit Banhazi, Daniel A Ollendorf, Mohit Jain, Sheela Upadhyaya, Wim G Goettsch","doi":"10.1017/S0266462324000187","DOIUrl":"https://doi.org/10.1017/S0266462324000187","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}