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处方药与医疗器械的交叉领域:两类新兴健康技术的评估与资金投入挑战

The intersection of prescription drugs and medical devices: the evaluation and funding challenges of two categories of emerging health technologies.

作者信息

Rodrigues Caroline, Fu Rui, Ghose Turjoy, Yurga Emre, Nauenberg Eric

机构信息

Institute for Management and Innovation, University of Toronto, Mississauga, ON, Canada.

Departments of Community Health Sciences, Surgery & Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

出版信息

Int J Technol Assess Health Care. 2024 Nov 29;41(1):e1. doi: 10.1017/S0266462324004768.

Abstract

Health technology assessments (HTAs) are policy analysis frameworks contributing to the approval, reimbursement, and rollout of biotechnology and pharmaceuticals. New innovations in health technologies expose gaps in reimbursement and implementation guidelines. We defined two types of emerging health technologies: (1) therapeutic innovations, such as drug-device combination products or nondrug alternatives to prescription drugs and (2) disruptive health innovations such as novel surgeries and gene replacement therapies. We aimed to determine delineated definitions for these categories through a comprehensive review of HTA guidelines across 20 nations. Utilizing databases such as International Network of Agencies for HTA, International Society for Pharmacoeconomics and Outcomes Research, and European Medical Agency, we identified products falling within these categories. Real-world case studies highlighted the inadequacies stemming from the absence of clear definitions and proposed solutions to enhance current HTA guidelines. These shortcomings apply at the state or provincial level in addition to national jurisdictions as existing funding structures and silos fail to accommodate the unique attributes of these technologies.

摘要

卫生技术评估(HTA)是有助于生物技术和药品审批、报销及推广的政策分析框架。卫生技术领域的新创新暴露了报销和实施指南方面的差距。我们定义了两种新兴卫生技术:(1)治疗性创新,如药物-器械组合产品或处方药的非药物替代方案;(2)颠覆性卫生创新,如新型手术和基因替代疗法。我们旨在通过全面审查20个国家的HTA指南来确定这些类别的明确界定。利用国际卫生技术评估机构网络、国际药物经济学与成果研究学会和欧洲药品管理局等数据库,我们确定了属于这些类别的产品。实际案例研究突出了因缺乏明确界定而产生的不足,并提出了加强现行HTA指南的解决方案。由于现有的资金结构和部门壁垒无法适应这些技术的独特属性,这些缺点不仅适用于国家管辖范围,也适用于州或省级层面。

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