Rosselli Diego, Quirland-Lazo Camila, Csanádi Marcell, Ruiz de Castilla Eva María, González Nelly Cisneros, Valdés Julio, Abicalaffe Cesar, Garzón William, Leon Giovanny, Kaló Zoltán
Medical School, Pontificia Universidad Javeriana, Bogota, Colombia.
Escuela de Salud Pública, Universidad de Chile, Santiago, Chile.
Value Health Reg Issues. 2017 Dec;14:20-27. doi: 10.1016/j.vhri.2017.02.004. Epub 2017 May 15.
To provide an overview about the current status of health technology assessment (HTA) implementation in Latin American countries and to identify long-term objectives considering regional commonalities.
We conducted a survey among participants of the 5th Latin American Future Trends Conference in October 2015. Thirty-seven respondents from eight Latin American countries provided insights about the current and preferred future status of HTA implementation related to human capacity building, HTA financing, process and organizational structure for HTA, scope of mandatory HTA, decision criteria, standardization of HTA methodology, mandating the use of local data, and international collaboration in HTA.
Survey respondents reported insufficient human resources and public investment for HTA implementation. Organizational structure and legislation framework of HTA differ considerably across countries. According to survey respondents, in the future policymakers should rely more on the assessment of therapeutic value, cost-effectiveness, and budget impact criteria by applying explicit thresholds, potentially in a multicriteria decision analysis framework. HTA should not be restricted to policy decisions of new technologies but it should also be used for the revision of previous decisions. In addition, the quality and transparency of HTA have to be strengthened.
HTA plays an increasingly important role in Latin American countries. Each country needs to record its current implementation status and identify components for improvement. Duplication of efforts can be reduced if international collaboration is integrated into national HTA implementation.
概述拉丁美洲国家卫生技术评估(HTA)实施的现状,并根据区域共性确定长期目标。
我们在2015年10月举行的第五届拉丁美洲未来趋势会议的参会者中开展了一项调查。来自八个拉丁美洲国家的37名受访者就HTA实施在人力能力建设、HTA融资、HTA流程与组织结构、强制HTA范围、决策标准、HTA方法标准化、强制使用本地数据以及HTA国际合作等方面的当前及理想的未来状况发表了见解。
受访者报告称,HTA实施的人力资源和公共投资不足。各国HTA的组织结构和立法框架差异很大。据受访者称,未来政策制定者应更多地依靠在多标准决策分析框架中应用明确阈值来评估治疗价值、成本效益和预算影响标准。HTA不应局限于新技术的政策决策,还应用于修订先前的决策。此外,必须加强HTA的质量和透明度。
HTA在拉丁美洲国家发挥着越来越重要的作用。每个国家都需要记录其当前的实施状况,并确定有待改进的方面。如果将国际合作纳入国家HTA实施中,则可以减少工作的重复。