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评估 COVID-19 相关技术:卫生技术评估机构面临的挑战有哪些?一项调查和专题研讨会的结果。

Assessing Technologies for COVID-19: What are the Challenges for Health Technology Assessment Agencies? Findings From a Survey and Roundtable Workshop.

机构信息

National Institute for Health and Care Excellence (NICE), Manchester, UK.

National Institute for Health and Care Excellence (NICE), London, UK.

出版信息

Pharmacoeconomics. 2021 Dec;39(12):1455-1463. doi: 10.1007/s40273-021-01097-4. Epub 2021 Oct 12.

Abstract

BACKGROUND

To date, health technology assessment (HTA) agencies have not been at the forefront of decision making regarding the adoption of interventions for coronavirus disease 2019 (COVID-19). Instead, policymakers have prioritised rapid action in response to the pandemic emergency, with no assessment of value for money. As COVID-19 vaccination coverage increases and healthcare systems begin to recover, HTA agencies will be expected to assess technologies for COVID-19.

OBJECTIVE

We aimed to identify the key challenges when assessing therapeutic and diagnostic technologies for COVID-19, from the perspective of HTA agencies, and identify whether there is a case for novel HTA methods and/or processes to address them.

METHODS

We used a mixed-methods approach, by conducting an online survey of HTA agencies, to collect data about the challenges faced when assessing or planning to assess diagnostic and therapeutic technologies for COVID-19. The online survey was followed by a 'roundtable' workshop of HTA agencies' representatives to discuss the results and to elaborate on their responses.

RESULTS

We received 21 completed surveys (response rate of 45%) and 11 of the respondents joined the roundtable discussion. Five themes emerged from the responses: assessing clinical effectiveness (44%), assessing cost effectiveness (19%), practical (19%), political (11%), and decision making (11%) challenges. At the roundtable, attendees elaborated on the challenges and identified two additional themes: how HTA agencies have responded to the pandemic to date, and how their role might change over time.

CONCLUSION

HTA agencies face both methodological and logistical challenges when assessing or planning to assess technologies for COVID-19. An interim best-practice HTA framework to address the key challenges would be valuable.

摘要

背景

迄今为止,卫生技术评估(HTA)机构在决定采用针对 2019 年冠状病毒病(COVID-19)的干预措施方面并未处于决策的前沿。相反,决策者优先考虑对大流行紧急情况采取快速行动,而不对其资金价值进行评估。随着 COVID-19 疫苗接种覆盖率的提高和医疗保健系统开始恢复,HTA 机构将需要评估 COVID-19 相关技术。

目的

我们旨在从 HTA 机构的角度确定评估 COVID-19 治疗和诊断技术时的关键挑战,并确定是否有必要采用新的 HTA 方法和/或流程来解决这些问题。

方法

我们采用混合方法,通过对 HTA 机构进行在线调查,收集有关评估或计划评估 COVID-19 诊断和治疗技术时面临的挑战的数据。在线调查之后,由 HTA 机构代表举行了一次“圆桌会议”研讨会,以讨论结果并详细说明其答复。

结果

我们收到了 21 份完整的答复(回应率为 45%),其中 11 名答复者参加了圆桌会议讨论。从答复中得出了五个主题:评估临床效果(44%),评估成本效益(19%),实用性(19%),政治(11%)和决策(11%)挑战。在圆桌会议上,与会者详细讨论了这些挑战,并确定了另外两个主题:HTA 机构迄今为止对大流行的应对方式,以及它们的角色随时间的变化方式。

结论

HTA 机构在评估或计划评估 COVID-19 相关技术时面临着方法和后勤方面的挑战。建立一个解决关键挑战的临时最佳实践 HTA 框架将是有价值的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b454/8599393/338f8b2a73eb/40273_2021_1097_Fig1_HTML.jpg

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