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利益相关方参与拉丁美洲的卫生技术评估过程。

STAKEHOLDER INVOLVEMENT IN THE HEALTH TECHNOLOGY ASSESSMENT PROCESS IN LATIN AMERICA.

机构信息

Institute for Clinical Effectiveness and Health Policy.

Institute for Clinical Effectiveness and Health

出版信息

Int J Technol Assess Health Care. 2018 Jan;34(3):248-253. doi: 10.1017/S0266462318000302. Epub 2018 Jun 11.

Abstract

OBJECTIVES

Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum.

METHODS

The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry. A background paper and presentations by invited experts and Forum members supported discussions. This study presents a summary of these discussions.

RESULTS

Stakeholder involvement in HTA remains inconsistently implemented in the region and few countries have established formal processes. Participants agreed that stakeholder involvement is key to improve the HTA process, but the form and timing of such improvements must be adapted to local contexts. The legitimization of both HTA and decision-making processes was identified as one of the main reasons to promote stakeholder involvement; but to be successful, the entire system of assessment and decision making must be properly staffed and organized, and certain basic conditions must be met, including transparency in the HTA process and a clear link between HTA and decision making.

CONCLUSIONS

Participants suggested a need for establishing clear rules of participation in HTA that would protect HTA producers and decision makers from potentially distorting external influences. Such rules and mechanisms could help foster trust and credibility among stakeholders, supporting actual involvement in HTA processes.

摘要

目的

拉丁美洲国家正在采取重要步骤来扩大和加强全民健康覆盖,而卫生技术评估(HTA)在这一过程中发挥着越来越突出的作用。所有相关利益攸关方的参与已成为这一努力的优先事项。在这一领域的关键问题在 2017 年拉丁美洲卫生技术评估国际(HTAi)政策论坛上进行了讨论。

方法

该论坛包括来自拉丁美洲 HTA 机构、公共、社会保险和私人保险部门以及制药和医疗器械行业的 41 名参与者。一份背景文件和特邀专家和论坛成员的介绍支持了讨论。本研究总结了这些讨论。

结果

利益攸关方参与 HTA 的情况在该地区仍不一致,只有少数几个国家建立了正式的程序。与会者一致认为,利益攸关方的参与是改善 HTA 过程的关键,但这种改进的形式和时间必须适应当地情况。HTA 和决策过程的合法化被认为是促进利益攸关方参与的主要原因之一;但要取得成功,评估和决策整个系统必须得到适当的人员配备和组织,并且必须满足某些基本条件,包括 HTA 过程的透明度以及 HTA 和决策之间的明确联系。

结论

与会者认为有必要制定明确的 HTA 参与规则,以保护 HTA 生产者和决策者免受潜在的扭曲外部影响。这些规则和机制可以帮助在利益攸关方中建立信任和信誉,支持他们实际参与 HTA 过程。

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