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OVERCOMING THE BARRIERS TO ACHIEVING UNIVERSAL HEALTH CARE IN THE ASIAN REGION

Part of: Special Collection - Policy Forums

Published online by Cambridge University Press:  10 July 2018

Linda Mundy Open the ORCID record for Linda Mundy [Opens in a new window] ,
Rebecca Trowman  and
Brendon Kearney
Linda Mundy
Affiliation:
School of Public Health, Faculty of Health and Medical Sciences, University of [email protected]
Rebecca Trowman
Affiliation:
HTAi Policy Forum and Interest Group Manager, HTAi
Brendon Kearney
Affiliation:
Chair, HTAi Asia Policy Forum, Department of Haematology, Royal Adelaide Hospital, South Australia
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Abstract

Objectives:

The Health Technology Assessment International (HTAi) Asia Policy Forum (HAPF) met to discuss the challenges of achieving universal health care (UHC) in Asia.

Methods:

Group discussions and presentations at the 2017 HAPF, informed by a background paper, including a literature review and the results of pre-meeting surveys of health technology assessment (HTA) agencies and industry, formed the basis of this article.

Results:

Affordability was identified as the greatest barrier to establishing UHC; however, other impediments include the lack of political will to implement UHC, and the cultural issue of deference to expert opinion instead of evidence-based assessments. Although HTA was identified as an important prioritization tool when adding new technologies to benefit packages, it is used inconsistently in the region, resulting in a less transparent decision-making process for stakeholders. Although regional challenges exist around real-world data (RWD), including a lack of capacity to enable information and data sharing, most policy or funding decision makers in the region have access to data. However, there appears to be a disconnect with the experience of industry, whose representatives identify the lack of RWD as their primary issue. To overcome these issues, both HTA agencies and industry agree that collaboration and transparency should be fostered to support the development of robust evidence generation in the region.

Conclusions:

There is a willingness for HTA agencies and industry to collaborate to develop HTA methodology for the prioritization of technologies in the Asia region that support healthcare systems to achieve the ultimate outcome of UHC.

Keywords

Universal coveragePatient generated health dataTechnology assessmentHealthDecision making
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 4 , 2018 , pp. 352 - 359
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

The authors thank the members of the HTAi Asia Policy Forum and, in particular, the members of the Policy Forum Organizing Committee and invited speakers who attended the 2017 meeting. This article is based on discussions at the HTAi 2017 Asia Policy Forum held November 2 to 3 in Beijing, China.

References

REFERENCES

1.OECD, WHO (2016). Health at a Glance: Asia/Pacific 2016: Measuring Progress towards Universal Health Coverage. Organisation for Economic Co-operation and Development, Paris. http://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-asia-pacific_23054964 (accessed June 7, 2018).Google Scholar
2.Chootipongchaivat, S, Tritasavit, N, Luz, A, et al. (2015). Conducive factors to the development of health technology assessment in Asia: Impacts and policy options. World Health Organization, Geneva, Switzerland. http://www.idsihealth.org/wp-content/uploads/2016/02/CONDUCIVE-FACTORS-TO-THE-DEVELOPMENT_resize.pdf (accessed June 7, 2018).Google Scholar
3.Hashim, J, Chongsuvivatwong, V, Hong, Phua K, et al. Health and Healthcare Systems in Southeast Asia. https://unu.edu/publications/articles/health-and-healthcare-systems-in-southeast-asia.html (accessed September 18, 2017).Google Scholar
4.WHO. Health financing for universal coverage. http://www.who.int/health_financing/universal_coverage_definition/en/ (accessed September 1, 2017).Google Scholar
5.Ottersen, T, Norheim, OF. Making fair choices on the path to universal health coverage. Bull World Health Organ. 2014;92:389.Google Scholar
6.Savedoff, WD, de Ferranti, D, Smith, AL, et al. Political and economic aspects of the transition to universal health coverage. Lancet. 2012;380:924-932.Google Scholar
7.Voorhoeve, A, Edejer, TTT, Kapiriri, L, et al. Three case studies in making fair choices on the path to universal health coverage. Health Hum Rights. 2016;18:11-22.Google Scholar
8.Chatham House. Chatham House Rule. https://www.chathamhouse.org/about/chatham-house-rule (accessed November 24, 2017).Google Scholar
9.Yu, H. Universal health insurance coverage for 1.3 billion people: What accounts for China's success? Health Policy. 2015;119:1145-1152.Google Scholar
10.Latko, B, Temporao, JG, Frenk, J, et al. The growing movement for universal health coverage. Lancet. 2011;377:2161-2163.Google Scholar
11.Abiiro, GA, De Allegri, M. Universal health coverage from multiple perspectives: A synthesis of conceptual literature and global debates. BMC Int Health Hum Rights. 2015;15:17.Google Scholar
12.Sen, A. Universal health care: The affordable dream. Harvard Public Health Review [serial on the Internet]. 2015. (Global Health). http://harvardpublichealthreview.org/wp-content/uploads/2015/04/HPHRv4-Sen-Lamont-UCH-Affordable-Dream.pdf (accessed June 7, 2018).Google Scholar
13.Bredenkamp, C, Evans, T, Lagrada, L, et al. Emerging challenges in implementing universal health coverage in Asia. Soc Sci Med. 2015;145:243-248.Google Scholar
14.Mues, KE, Liede, A, Liu, J, et al. Use of the Medicare database in epidemiologic and health services research: A valuable source of real-world evidence on the older and disabled populations in the US. Clin Epidemiol. 2017;9:267-277.Google Scholar
15.Jarow, JP, LaVange, L, Woodcock, J. Multidimensional evidence generation and FDA regulatory decision making: Defining and using “real-world” data. JAMA. 2017;318:703-704.Google Scholar
16.Lee, JT, Majeed, A, Millett, C. User fees in universal health systems. Lancet. 2012;380:1643-1644.Google Scholar