Learning Health Technology Assessment made easy and exciting: A joint effort by NUS & HITAP

By Yashika Chugh

In the context of emerging newer drugs, diagnostic equipment and continuously rising costs of health care, health technology assessment (HTA) serves as an important tool for rational decision making and guiding policy actions. As there are limited experts in this field, it requires involving and training more people so that HTA can be effectively used for rational decision making in the field of health. With the aim of building capacity in HTA in the region, the Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS) in collaboration with the Health Intervention and Technology Assessment Program (HITAP) held a workshop under the theme of Health Technology Assessment: Selecting the Highest Value Care, followed by a  policy symposium on the third day. Participants came from Singapore and other countries namely, India, Malaysia, Hong Kong, Thailand, Philippines, Indonesia and Ghana.

As a part of my Master in Public Health (MPH) from the Post-graduate Institute of Medical Sciences and Research (PGIMER) Chandigarh, India, I have an opportunity to experience hands-on research work as an intern at HITAP. In my first week with HITAP, I had a chance to attend the HTA workshop in Singapore which helped me revise the concepts of health economics, learn how to have my work reflect the required policy change and also introduced me to certain new aspects of conducting a HTA. I am glad to share my experience from attending this workshop so as to impart what I gained from this amazing opportunity.

The training during the first two days was led by 11 health economics experts from NUS, HITAP, the World Health Organization (WHO) and the University of Southern California. This part of the training was centred on introducing the basic concepts of both health economics and HTA. The session covered wide range of important topics in conducting economic evaluation (EE) and HTA such as the selection of topics for HTA, the approach to conducting HTA, the evidence synthesis, and the cost and outcome measures for modelling in the EE as well as advanced concepts of sensitivity analysis and budget impact analysis presented by Ms. Joanne Yoong (University of Southern California) and Ms. Waranya Rattanavipapong (HITAP), respectively. From my perspective, the best part was that all the concepts taught used the economic evaluations conducted by the speakers as a reference. This demonstrates how the theoretical concepts can actually be applied while conducting HTA.  The highlight element of the training session was hands-on exercises conducted in-between to help participants truly understand the concept of Quality Adjusted Life Years (QALYs) and modelling while helping them learn how to actually handle the data while conducting HTA.

 

 

The workshop was followed by a policy symposium where around 14 eminent speakers from round the globe shared their experiences of conducting HTA. The symposium mainly focused on HTA studies and its development in Asian countries, particulary in Thailand, India, Singapore, and Indonesia. The experiences shared by the speakers demonstrate that HTA has been used to inform decisions on drug policies which has definitely provided good value for money to governments. It was highlighted that methodological differences do exist across various settings and a platform known as the Guide to Economic Analysis and Research or GEAR (an online resource) provides information about HTA guidelines from various countries as well as, the importance of stakeholder consultation which is an important process in conducting HTA. From my standpoint, such an insight is meaningful for all countries, which they should consider while conducting and delivering HTA-based research.

As far as India is concerned, I realised that there should be a more rigorous procedure for stakeholder consultation. Also, using HTA extensively to devise the essential medicine list is another area where I feel we could learn from other countries. Though we are on the right track as policy changes are taking place considering HTA as an evidence base, the dissemination of the conducted research is another area where we need to progress more.

HTA provides an evidence base for the formation of sustainable health policies and choosing between available health interventions for the overall good of the public. However, it is well known that there is a dearth of human resource in this field. Such training and hands-on workshops will definitely enhance individual’s abilities in this domain. Also, as these workshops, as being conducted at the global level, they will foster healthy collaborations so that HTA can be incorporated in every aspect of decision making for the benefit of the people.