Изграждане на капацитет и институционализиране на структура за оценка на здравни технологии – сравнителен анализ на междинната мезо среда между България и добрите международни практики
Abstract
Въведение: Създаването на организация за оценка на здравни технологии (ОЗТ), която да информира политически решения, е амбициозна мисия. Липсват стандартни подходи, поради разликите в средата, в която ще се развива ОЗТ капацитета.
Цел: Целта е да се систематизират и анализират най-добрите ОЗТ практики в глобален мащаб и да се извърши съпоставка на характеристиките на средата с постигнатото в България ниво на изграждане на капацитет.
Материал и методи: В периода 2013–2015 г. е проведено международно уеб-базирано анкетно проучване сред 312 ОЗТ организации, включително 11 международни. Данните са получени от полу-структуриран въпросник, който съдържа общо 106 въпроса. Анализът на данните е реализиран със статистическия пакет IBM SPSS Statistics v. 22, Microsoft Office Excel 2013, Provalis Research QDA Miner 4 и WordStat 7.
Резултати: Попълнени са 111 въпросника (35.58% възвращаемост) от 39 държави на 5 континента. Изграждането на капацитет и институционализирането започва от макросредата с идентифициране на потребността от създаване на ОЗТ структура на най-високо политическо и административно ниво и продължава с обособяване на междинната мезо среда. Това измерение най-общо включва привличането от една страна на външни експерти и консултанти, от друга на заинтересованите страни, както и създаването на мрежа от международни връзки и колаборации.
Заключение: Улесняването на изграждане на капацитет и осигуряването на устойчиво развитие на ОЗТ структура изисква детайлно опознаване на външната среда. За преодоляване на възможните конфликти и бариери е важно взаимосвързано възприемане на проблемите, без съсредоточаване върху само един ограничаващ фактор.
References
Gulácsi L, Brodszky V, Péntek M, Varga S, et. al. History of Health Technology Assessment in Hungary. International Journal of Technology Assessment in Health Care 2009;25 Suppl 1: 120–126.
Nizakowski R, Wilk N. From idealistic rookies to a regional leader: the history of health technology assessment in Poland. Int J Technol Assess in Health Care 2009; 25 Suppl:156-62.
Moga C, Corabian P, Harstall C, et al. Developing health technology assessment in Romania. Eurohealth. 2003;9:30-34.
Jankauskiene D; Development of health technology assessment in Lithuania. Int J of Technology Assessment in Health Care, 25: Supplement 1, (2009). 140 – 142.
Muratov S, Hailey D, Foerster V, Brady B, Juzwishin D, la Fleur P, et al. Mentoring a health technology assessment initiative in Kazakhstan. Int J Technol Assess Health Care. 2014;30:147–52.
Hisashige A. History of healthcare technology assessment in Japan International Journal of Technology Assessment in Health Care, 25 (2009), pp. 210–218.
Chen YY, Banta D, Tang ZL. Health technology assessment development in China Int J Technol Assess Health Care, 25 (Suppl. 1) (2009), pp. 202–209.
Pwee KH. Health technology assessment in Singapore. Int J Technol Assess Health Care 2009; 25 Suppl 1: 234-40.
Kim C. Health technology assessment in South Korea International Journal of Technology Assessment in Health Care, 25 (Suppl. 1) (2009), pp. 219–223.
Sivalal S. Health technology assessment in Malaysia. Int J Technol Assess Health Care. 2009;25(S1):224–30.
Teerawattananon Y, Tantivess S, Yothasamut J, Kingkaew P, Chaisiri K (2009) Historical development of health technology assessment in Thailand. Int J Technol Assess Health Care 25: Suppl 1241–252.
Doaee SH, Olyaeemanesh A, Emami SH, Mobinizadeh M, Abooee P, Nejati M, Zolani GS: Development and Implementation of Health Technology Assessment: A Policy Study. Iranian Journal of Public Health 2013, 42:50–54.
Chauhan SB, Agrawal SS. Health Technology Assessment in India: Present status and future perspectives; J. Adv. Pharm. Edu. & Res. 2014: 4(1): 13-19.
Banta D. Health technology assessment in Latin America and the Caribbean Int J Technol Assess Health Care, 25 (Suppl. 1) (2009), pp. 253–254.
Gulácsi L, Orlewska E, Péntek M. Health economics and health technology assessment in Central and Eastern Europe: a dose of reality. Eur J Health Econ. 2012 Oct;13(5):525-31.
Sivalal S, Banta D, T’Hoen E, Jaudin R. Training in health technology assessment. Int J Technol Assess Health Care. 1998;14:809-817.
Pitayarangsarit S, Tangcharoensathien V. Beyond training: Thailand experiences on sustaining capacity in health policy and systems research. Nonthaburi: International Health Policy Program. 2008.
Stephens JM, Handke B, Doshi JA, et al. International survey of methods used in health technology assessment (HTA): Does practice meet the principles proposed for good research? J Comp Eff Res. 2012;2:29-44.
Hailey D. Elements of effectiveness for health technology assessment programs. HTA Initiative #9. Edmonton (Canada): Alberta Heritage Foundation for Medical Research (AHFMR); 2003
Moharra M, Kubesch N, Estrada MD, Parada A, Cortes M, Espallargues M on behalf of Work Package 8, European Network for Health Technology Assessment and Research (EUnetHTA project). Survey report on HTA organisations. Barcelona (Spain): Catalan Agency for Health Technology Assessment and Research. Catalan Health Service. Department of Health. Autonomous Government of Catalonia; May 2008
Mears R, Taylor R. Littlejohns P, Dillon A. Review of International Health Technology Assessment (IHTA). Project report. London: National Institute for Clinical Excellence (NICE); 2000
Moharra M, EspallarguesM, Kubesch N, Estrada MD, Parada A, Vondeling H, et al. Systems to support health technology assessment (HTA) in Member States of the European Union with limited institutionalization of HTA. Int J Technol Assess Health Care 2009; 25 (Suppl 2): 75-83.
Райчева Р. Стефанов Р. Мрежи за международно сътрудничество в областта на оценката на здравни технологии – поглед в настоящето и бъдещи предизвикателства. Asklepious, X (XXIX), 2015(1):98-105.
Kristensen FB. Development of European HTA: from Vision to EUnetHTA Michael Q, 9 (2012), pp. 147–156.
Kristensen FB, Lampe K, Chase DL, Lee-Robin SH, Wild C, Moharra M, Garrido MV, Nielsen CP, Røttingen JA, Neikter SA, Bistrup ML. Practical tools and methods for health technology assessment in Europe: structures, methodologies, and tools developed by the European Network for Health Technology Assessment, EUnetHTA. Int J Technol Assess Health Care 2009;25(Suppl. 2):1-8.
The OECD Health Project. Health Technologies and Decision Making. Paris (France): OECD Publishing; 2005.
Gulácsi L. Future challenges for health economics and health technology assessment of biological drugs. Eur J Health Econ 2010;11:235-238.
Kristensen FB. What is health technology assessment-and how is European Network for HTA (EUnetHTA) developing transnational collaboration? (2007, September) From International Society for Pharmacoeconomics and Outcomes Research. Webpage. Available at: https://www.ispor.org/news/articles/Oct08/LatinAmericaHTA.asp; Accessed on: 26 Sept 2015.
Estrada MD, Serra-Sutton V, Rajmil L. Overview of the implementation of the health technology assessment activities in a broad representation of world health organisation-collaborating centres. Barcelona: Catalan Agency for Health Technology Assessment and Research; 2002
International Health Technology Assessment International (HTAi) [homepage on the Internet]. Edmonton (Canada). International Health Technology Assessment International; Available from http://www.htai.org Accessed on 04.06.2015
Banta D, Jonsson E. History of HTA: Introduction. International Journal of Technology Assessment in Health Care 2009; 25 (Supplement 1): 1-6.
Resolution WHA60.29. Health technologies. In: Sixtieth World Health Assembly, Geneva, 23 May 2007. Geneva, World Health Organisation, 2007 http://www.who.int/medical_devices/resolution_wha60_29-en1. pdf 23 January 2012
International Network of Agencies of Health Technology Assessment (INAHTA) [homepage on the Internet]. Stockholm (Sweden): The International Network of Agencies for Health Technology Assessment; Available from: http://www.inahta.org
Southern African Health technology Assessment Society – SAHTAS. Homepage. Available online. www.htasa.org.za Accessed July 31, 2015
Australia and New Zealand Horizon Scanning Network – ANZHSN. Homepage. Available online: http://www.surgeons.org/for-healthprofessionals/audits-and-surgical-research/asernips/systematicreviews-and-technology-overviews/. Accessed July 28, 2015.
Cochrane Collaboration. Homepage. http://www.cochrane.org/ (Accessed July 30, 2015)
World Health Organization (WHO). Health Technology Assessment (HTA) in WHO. http://www.who.int/medical_devices/assessment/history. pdf?ua=1 (Accessed July 30, 2015)
World Health Organization (WHO). Health technology assessment of medical devices. World Health Organization, Switzerland, Geneva, 2011
World Health Organization (WHO). Global collaborations. Webpage. http://www.who.int/medical_devices/collaborations/en/ (Accessed July 30, 2015)
World Health Organization (WHO). Global collaborations. Webpage. http:// www.who.int/medical_devices/assessment/signed_mou_euroscan. pdf?ua=1 / (Accessed July 30, 2015)
World Health Organization (WHO). Global collaborations. Webpage. http://www.who.int/medical_devices/assessment/signed_mou_htai. pdf?ua=1 / (Accessed July 30, 2015)
World Health Organization (WHO). Global collaborations. Webpage. http://www.who.int/medical_devices/assessment/signed_mou_inahta. pdf?ua=1/ (Accessed July 30, 2015)
World Health Organization (WHO). Global collaborations. Webpage. http://www.who.int/medical_devices/assessment/Signed_Amendment_ MOU_INAHTA_2015.pdf?ua=1 / (Accessed July 30, 2015)
Canadian Society for International Health (CSIH). History. Webpage. http://www.csih.org/en/about/history/ (Accessed July 31, 2015)
International Society for Pharmacoeconomics and Outcomes Research (ISPOR). About ISPOR. Webpage. http://www.ispor.org/about-ispor.asp (Accessed July 31, 2015)
International Society for Pharmacoeconomics and Outcomes Research (ISPOR). ISPOR Milestones. CELEBRATING A 20-YEAR HISTORY THAT IS SHAPING THE FUTURE OF HEALTH ECONOMICS AND OUTCOMES RESEARCH. Available online. http://www.ispor.org/ISPOR-20thAnnivMilestones-Brochure.pdf (Accessed July 31, 2015)
Jonsson E: History of health technology assessment in Sweden. Int J Technol Assess Health Care 2009, 25(Suppl 1):42-52.
Mørland B. The history of health technology assessment in Norway. International Journal of Technology Assessment in Health Care 2009;25, pp148-155.
Banta D, Kristensen FB, Jonsson E. A history of health technology assessment at the European level. Int J Technol Assess Health Care 2009; 25 (Suppl 1): 68-73.
Banta HD, Luce BR. Health care technology and its assessment. An international perspective. Oxford & New York, Oxford University Press, 1993.
Banta D, Luce B. Health technology assessment and its assessment. Oxford: Oxford University Press; 1993
Rubinstein A, Pichon-Riviere A, Augustovski F (2009) Development and implementation of health technology assessment in Argentina: two steps forward and one step back. Int J Technol Assess Health Care 25 Suppl 1260–269.
World Health Organization (WHO). Global collaborations. Webpage. http://www.who.int/medical_devices/assessment/resolution_amro_ csp28.r9.pdf/ (Accessed July 30, 2015)
Granados A, Sampietro-Colom L, Asua J, Conde J, Vazquez-Albertino R. Health technology assessment in Spain. Int J Technol Assess Health Care. 2000;16:532-559
Sigmund H, Kristensen FB. Health technology assessment in Denmark: strategy, implementation, and developments. Int. J. Technol. Assess. Health Care. 2009; 25(Suppl. 1): 94–101.
Lauslahti K, Roine RP, Semberg V, et al. Health technology assessment in Finland. Int J Technol Assess Health Care. 2000;16:382-399.
Perleth M, Gibis B, Gohlen B: A short history of health technology assessment in Germany. Int J Technol Assess Health Care 2009, 25(Suppl 1):112-119.
Koch P, Schilling J, Läubli M, Mitscherlich F, Melchart D, Bellucci S. Health technology assessment in Switzerland. International Journal of Technology Assessment in Health Care 2009;25(Suppl. 1):174-177.
Favaretti C, Cicchetti A, Guarrera G, et al. Health technology assessment in Italy. Int J Technol Assess Health Care. 2009;25((Suppl 1)):127–133.
Hailey D. The history of health technology assessment in Australia. Int J Technol Assess Health Care. 2009;25 Suppl 1:61-7.
Wild C. Austria: History of health technology assessment during the past 20 years. Int J Technol Assess Health Care. 2009;25 Suppl 1:74–81.
Agency for Quality and Accreditation in Health Care (Agencija za kvalitetu i akreditaciju u zdravstvu i socijalnoj skrbi). Homepage. Available at: http://aaz.hr/hr/projekti; Accessed on: 30 Sept 2015
Jonsson E, Banta HD, Henshall C, Sampietro-Colom L. Report from the ECHTA-ECAHI Project. European collaboration for health technology assessment: developing an assessment network. Int J Technol Assess Health Care. 2002; 18(2):213-455.
Hailey D. Toward transparency in health technology assessment. A checklist for HTA reports. Int J Technol Assess Health Care. 2003;19:1- 7.
Liberati A, et al. EUR-ASSESS Project subgroup report on methodology. Int J Technol Assess Health Care. 1997;13:186-219.
Velasco M, Perleth M, Drummoud M, et al. Best practice in undertaking and reporting health technology assessments. Int J Technol Assess Health Care. 2002;18:361-422.
The Pan American Health Organization (PAHO). Health Technology Assessment. Webpage. Available at: http://www.paho.org/hq/index. php?option=com_topics&view=article&id=131&Itemid=40823&lang =en; Accessed July 30, 2016
HTAsiaLink. Website. http://www.htasialink.org/about/history.php (Accessed July 31, 2015)
Menon D, Marshall D. The Internationalization of Health Technology Assessment. International Journal of Technology Assessment in Health Care. 1996;12, pp 45-51
European Commission. Public Health Policy. Available at: http:// ec.europa.eu/health/technology_assessment/policy/index_en.htm. Last accessed March 2, 2012.
Dalli J. Commissioner Dalli Addresses the EUnetHTA Conference 2011: HTA in National and Cross-Border Healthcare in Europe [Transcript]. December 8, 2011. Available at: http://ec.europa.eu/ commission_2010-2014/dalli/docs/speech_08122011_en.pdf.
Sepulveda B, Doyle JJ, White C. THE EFFECTS OF NICE HTA ON DRUG PRESCRIBING AND EXPENDITURES IN THE US. Quintiles Consulting, Hawthorne, NY, USA, May 18, 2009
Deverka PA, Lavallee DC, Desai PJ, Esmail LC, Ramsey SD, Veenstra DL, et al. Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement. J Comp Eff Res. 2012; 1(2): pp.181-94.
Health Information and Quality Authority. Guidelines for Stakeholder Engagement in Health Technology Assessment in Ireland. Health Information and Quality Authority, Dublin Regional Office, 2014.
Kristensen FB. EUnetHTA and health policy-making in Europe. Eurohealth, 2006;12(1):36–38.
Kristensen FB, Sigmund H (2007). Health technology assessment handbook. Copenhagen, Danish Centre for Health Technology Assessment, National Board of Health.
OECD. OECD Health Project – health technologies and decision making. Paris, OECD Publishing 2005.
Battista R, Hodge MJ. The evolving paradigm of health technology assessment: reflections for the Millennium. Journal of the Canadian Medical Association, 1999, 160(10):1464-1467
Lehoux P, Tailliez S, Denis JL, Hivon M. Redefining HTA in Canada: diversification of products and contextualization of findings International Journal of Technology Assessment in Health Care, 20 (3) (2004), pp. 325–336;
EUnetHTA Work Package 8. EUnetHTA Handbook on Health Technology Assessment Capacity Building. Barcelona (Spain): Catalan Agency for Health Technology Assessment and Research. Catalan Health Service. Department of Health Autonomous Government of Catalonia; 2008.
Съдържанието е достъпно под лиценза Creative Commons Attribution-NonCommercial 4.0 International License.