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[欧洲医疗器械评估合作:迈向跨境医疗保健的一步]

[European Collaboration in Medical Device Assessment: One Step Towards Cross-Border Health Care].

作者信息

Mayer Julia, Ettinger Sabine, Nachtnebel Anna

机构信息

Ludwig Boltzmann Institut für Health Technology Assessment, Wien, Österreich.

出版信息

Gesundheitswesen. 2018 Mar;80(3):210-216. doi: 10.1055/s-0043-109859. Epub 2017 Jun 19.

Abstract

AIM

The aim of this paper was to present the legal framework as well as previous experience in transnational collaboration regarding the assessment of medical devices for reimbursement decisions. Furthermore, the possible benefit of transnational collaboration for various stakeholders will be discussed.

METHODS

Experiences gathered with the compilation of overall 6 joint rapid assessments of medical devices within the completed European Network for Health Technology Assessment (EUnetHTA) Joint Action 2 (JA2) are summarised and discussed. Benefits, aims and opportunities of the ongoing EUnetHTA Joint Action 3 (JA3) are described.

RESULTS

Challenges in joint European assessment of medical devices encompass the choice of topics and the time point of assessments, the non-transparency of the medical devices market as well as the lack of European standards for systematic patient involvement. Characteristics of medical devices such as incremental changes and learning curves call for monitoring of medical devices through their whole lifecycle. The concrete benefit of European collaboration for stakeholders is manifold: uncertainties with regard to the actual added value of a technology, caused by a lack of evidence, may be reduced by Early Dialogues; harmonized and transparent assessment processes throughout Europe increase the reproducibility and quality of reports; the division of work among the health technology assessment (HTA) organisations allows a resource efficient assessment of a larger amount of technologies; patient involvement facilitates consideration of patient-relevant endpoints. The importance of cross-border collaboration in the field of HTA is shown in the continuation of the EUnetHTA project, which aims to further strengthen international collaboration even after expiration of EU funding.

CONCLUSION

A sustainable transnational collaboration in the assessment of medical devices can ensure cross-border health care as well as efficient collaboration of national health systems. The focus should be on a wide implementation of jointly established methods and quality standards. The European collaboration can lead to a concrete benefit for patients, physicians, HTA organisations and national decision makers.

摘要

目的

本文旨在介绍用于医疗设备报销决策评估的法律框架以及跨国合作的先前经验。此外,还将讨论跨国合作为各利益相关方可能带来的益处。

方法

总结并讨论了在已完成的欧洲卫生技术评估网络(EUnetHTA)联合行动2(JA2)中,对6项医疗设备联合快速评估进行汇编时所积累的经验。描述了正在进行的EUnetHTA联合行动3(JA3)的益处、目标和机遇。

结果

欧洲医疗设备联合评估中的挑战包括主题选择和评估时间点、医疗设备市场缺乏透明度以及缺乏系统性患者参与的欧洲标准。医疗设备的特性,如渐进性变化和学习曲线,要求在其整个生命周期内对其进行监测。欧洲合作给利益相关方带来的具体益处是多方面的:早期对话可以减少因证据不足导致的技术实际附加值的不确定性;欧洲各地统一且透明的评估流程提高了报告的可重复性和质量;卫生技术评估(HTA)组织之间的分工使对大量技术的评估更具资源效率;患者参与有助于考虑与患者相关的终点。HTA领域跨境合作的重要性在EUnetHTA项目的延续中得到体现,该项目旨在即使在欧盟资金到期后仍进一步加强国际合作。

结论

医疗设备评估中的可持续跨国合作可以确保跨境医疗保健以及国家卫生系统的高效协作。重点应放在广泛实施共同制定的方法和质量标准上。欧洲的合作可以为患者、医生、HTA组织和国家决策者带来切实的益处。

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