Pichon-Riviere Andrés, Soto Natalie C, Augustovski Federico Ariel, García Martí Sebastián, Sampietro-Colom Laura
Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina. La correspondencia se debe dirigir a Natalie C Soto. Correo electrónico:
Hospital Clinic de Barcelona, Barcelona, España.
Rev Panam Salud Publica. 2018 Feb 19;41:e138. doi: 10.26633/RPSP.2017.138.
Identify the most relevant, applicable, and priority good practice principles in health technology assessment (HTA) in Latin America, and potential barriers to implementing them in the region.
HTA good practice principles postulated worldwide were identified and then explored through a deliberative process in a forum of evaluators, funders, and technology producers.
Forty-two representatives from ten Latin American countries participated in the forum. The good practice principles postulated at the international level were considered valid and potentially applicable in Latin America. Five principles were identified as priorities and as having greater potential to be expanded at this time: transparency in carrying out HTA; involvement of stakeholders in the HTA process; existence of mechanisms to appeal decisions; existence of clear mechanisms for HTA priority-setting; and existence of a clear link between assessment and decision-making. The main challenge identified was to find a balance between application of these principles and available resources, to prevent the planned improvements from jeopardizing report production times and failing to meet decision-makers' needs.
The main recommendation was to gradually advance in improving HTA and its link to decision-making by developing appropriate processes for each country, without attempting to impose, in the short term, standards taken from examples at the international level without adequate adaptation to the local context.
确定拉丁美洲卫生技术评估(HTA)中最相关、适用且具优先性的良好实践原则,以及在该地区实施这些原则的潜在障碍。
确定全球范围内提出的HTA良好实践原则,然后在一个由评估人员、资助者和技术生产者组成的论坛上通过审议过程进行探讨。
来自十个拉丁美洲国家的42名代表参加了该论坛。国际层面提出的良好实践原则被认为在拉丁美洲是有效的且具有潜在适用性。确定了五项原则为优先事项且目前具有更大的扩展潜力:开展HTA时的透明度;利益相关者参与HTA过程;存在决策上诉机制;存在明确的HTA优先排序机制;评估与决策之间存在明确联系。确定的主要挑战是在应用这些原则与可用资源之间找到平衡,以防止计划中的改进危及报告制作时间且无法满足决策者的需求。
主要建议是通过为每个国家制定适当的流程,逐步推进改善HTA及其与决策的联系,而不是在短期内试图强行采用未经充分适应当地情况的国际范例标准。