Dankó Dávid
Corvinus University of Budapest, Institute of Management, Budapest, Hungary.
J Mark Access Health Policy. 2014 Mar 11;2. doi: 10.3402/jmahp.v2.23181. eCollection 2014.
Because of significant differences in institutional contexts, health technology assessment (HTA) systems that are in place in core pharmaceutical markets may not be suitable, fully or in part, for middle-income countries (MICs) and for other noncore markets. Particular challenges may arise when systems based on the economic evaluation paradigm are conceptualized and implemented in MICs, sometimes with an insufficient level of awareness of the local institutional factors that influence pricing and reimbursement decision making. Focusing on pharmaceuticals, this article investigates possible development directions for HTA systems in MICs and noncore markets bearing similar institutional characteristics, and it provides recommendations for a balanced assessment system (BAS). For this, the main paradigms of HTA have also been reviewed briefly and factors influencing HTA and pricing and reimbursement decisions in MICs and in similar noncore countries have been summarized. The proposed BAS framework takes into account available resources and capabilities and is supposed to facilitate access to new pharmaceuticals while ensuring the transparency of decision-making processes and the stability of the pharmaceutical budget.
由于制度背景存在显著差异，核心制药市场现有的卫生技术评估（HTA）系统可能完全或部分不适用于中等收入国家（MICs）和其他非核心市场。当基于经济评估范式的系统在中等收入国家进行概念化和实施时，可能会出现特殊挑战，有时对影响定价和报销决策的当地制度因素认识不足。本文聚焦于药品，研究了中等收入国家和具有类似制度特征的非核心市场中HTA系统可能的发展方向，并为平衡评估系统（BAS）提供了建议。为此，还简要回顾了HTA的主要范式，并总结了影响中等收入国家及类似非核心国家HTA以及定价和报销决策的因素。拟议的BAS框架考虑了可用资源和能力，旨在促进新药的可及性，同时确保决策过程的透明度和药品预算的稳定性。
