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STAKEHOLDER INVOLVEMENT IN THE HEALTH TECHNOLOGY ASSESSMENT PROCESS IN LATIN AMERICA

Part of: Special Collection - Policy Forums

Published online by Cambridge University Press:  11 June 2018

Andres Pichon-Riviere ,
Natalie Soto Open the ORCID record for Natalie Soto [Opens in a new window] ,
Federico Augustovski  and
Laura Sampietro-Colom
Andres Pichon-Riviere
Affiliation:
Institute for Clinical Effectiveness and Health Policy
Natalie Soto
Affiliation:
Institute for Clinical Effectiveness and Health [email protected]
Federico Augustovski
Affiliation:
Institute for Clinical Effectiveness and Health Policy
Laura Sampietro-Colom
Affiliation:
Hospital Clinic de Barcelona
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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.

Keywords

Universal coverageHealth economicsEvaluation of biomedical technologiesPublic health policyStakeholder involvementHealth priorities
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 3 , 2018 , pp. 248 - 253
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

To the event participants: Lizbeth Acuña (Cuenta de Alto Costo - Colombia), Julio Arias (Johnson&Johnson), Christine Bouchet (Alcon), Andrew Bruce (Amgen), Jaime Calderón Herrera (Instituto de Evaluación Tecnológica en Salud (IETS) - Colombia), Ramon Camacho (Merck), Vania Cristina Canuto Santos (Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC) - Brazil), Ricardo Castillo (Sanofi), Albin Chaves Matamoros (Caja Costarricense del Seguro Social - Costa Rica), Rafael de Feria (Ministerio de Salud - Chile), David Debrott Sánchez (Superintendencia de Salud - Chile), Jose Luis Estrada Aguilar (Intituto Mexicano del Seguro Social (IMSS) - Mexico), Fabián Fiestas-Saldarriaga (Seguro Social de Salud (EsSalud) - Peru), Veronica Gallegos Rivero (Centro Nacional de Excelencia Tecnológica en Salud (CENETEC) - Mexico), Margarita García (Ministerio de Salud - El Salvador), Christian David Gavilanes Castellanos (Ministerio de Salud Pública - Ecuador), Edgar Guerrero (Johnson&Johnson), Gisely Hijar Guerra (Instituto Nacional de Salud (INS) - Peru), Silvana Kelles (UNIMED - Brazil), Elsa Koutsavakis (Pfizer), Alexandre Lemgruber (Pan American Health Organization (PAHO) - PAHO), Kariluz Maestre (Novartis), Mercedes Manzioni (Instituto Nacional de Servicios Sociales para Jubilados y Pensionados - Argentina), Homero Monsanto (Merck), Sean Nagle (Novartis), Mariana Naranjo Muedano (Amgen), Manny Papadimitropoulos (Eli Lilly), Ana Pérez Galán (Ministerio de Salud - Uruguay), Joaquín Pinto (Roche), Monica Quijano (Novartis), Jocelyn Ramírez Gamez (Eli Lilly), Alarico Rodriguez (Fondo Nacional de Recursos - Uruguay), Raul Sanchez Kobashi (Sanofi), Ana Eduviges Sancho Jiménez (Ministerio de Salud - Costa Rica), Joice Valentim (Roche), Stefan Weber (Novartis). We also thank Tara Schuller for her work in translating the manuscript from Spanish to English. Financial support: The organization of and attendance at the Forum was financed by Health Technology Assessment International (HTAi). The preparation of this study was undertaken by the Institute for Clinical Effectiveness and Health Policy (IECS) with funding support from HTAi.

References

REFERENCES

1.Dmytraczenko, T, Torres, FM, Aten, A. Universal health coverage policies in Latin America and the Caribbean. Toward universal health coverage and equity in Latin America and the Caribbean: Evidence from selected countries. Washington, DC: International Bank for Reconstruction and Development/The World Bank; 2015:53–80.Google Scholar
2.Terwindt, F, Rajan, D, Soucat, A. Priority-setting for national health policies, strategies and plans. 2015 November 2016. In: Strategizing national health in the 21st century: A handbook [Internet]. Geneva: World Health Organization.Google Scholar
3.World Health Organization (WHO). Making fair choices on the path to universal health coverage 2014. http://apps.who.int/iris/bitstream/10665/112671/1/9789241507158_eng.pdf?ua=1 (accessed May 2, 2018).Google Scholar
4.Augustovski, F, Alcaraz, A, Caporale, J, Garcia Marti, S, Pichon Riviere, A. Institutionalizing health technology assessment for priority setting and health policy in Latin America: From regional endeavors to national experiences. Expert Rev Pharmacoecon Outcomes Res. 2015;15:9–12. doi:10.1586/14737167.2014.963560.Google Scholar
5.Banta, HD. Commentary on the article “Key principles for the improved conduct of health technology assessments for resource allocation decisions”. Int J Technol Assess Health Care. 2008;24:362–365.Google Scholar
6.Pichon-Riviere, A, Augustovski, F, Rubinstein, A, et al. Health technology assessment for resource allocation decisions: Are key principles relevant for Latin America? Int J Technol Assess Health Care. 2010;26:421–427. doi:10.1017/S0266462310001042.Google Scholar
7.Baltussen, R, Jansen, MP, Mikkelsen, E, et al. Priority setting for universal health coverage: We need evidence-informed deliberative processes, not just more evidence on cost-effectiveness. Int J Health Policy Manag. 2016;5:615–618. doi:10.15171/ijhpm.2016.83.Google Scholar
8.Pichon-Riviere, A, Soto, NC, Augustovski, FA, Garcia Marti, S, Sampietro-Colom, L. [Health technology assessment for decision-making in Latin America: Good practice principles]. Rev Panam Salud Publica. 2018;41:e138.Google Scholar
9.Daniels, N. Accountability for reasonableness. BMJ. 2000;321:1300–1301.Google Scholar
10.Daniels, N. Justice, health, and healthcare. Am J Bioeth. 2001;1:2–16. doi:10.1162/152651601300168834.Google Scholar
11.Drummond, MF, Schwartz, JS, Jonsson, B, et al. Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care. 2008;24:244–258; discussion 362-368. doi:10.1017/S0266462308080343.Google Scholar
12.EFPIA, editor. Position paper: The use of health technology assessments (HTA) to evaluate medicines - Key principles. Brussels: EFPIA; 2005.Google Scholar
13.HLPF. High Level Pharmaceutical Forum - 2005–2008 - Final Report: HLPF; 2008. http://www.anm.ro/_/Final%20Conclusions%20and%20Recommendations%20of%20the%20High%20Level%20Pharmaceutical%20Forum.pdf.Google Scholar
14.Siebert, M, Clauss, LC, Carlisle, M, et al. Health technology assessment for medical devices in Europe. Int J Technol Assess Health Care. 2002;18:733–740. doi:doi:null.Google Scholar
15.Sorenson, C, Drummond, M, Borlum, F, Busse, R. How can the impact of health technology assessments be enhanced? Copenhagen, Dinamarca: World Health Organization; 2008.Google Scholar
16.World Health Organization (WHO). Using Health Technology Assessment for Universal Health Coverage and Reimbursement Systems. Geneva, Switzerland: 2015. http://www.who.int/health-technology-assessment/HTA_November_meeting_report_Final.pdf?ua=1 (accessed May 2, 2018).Google Scholar
17.Pichon-Riviere, A, Soto, N, Augustovski, F, Garcia-Marti, S, Sampietro-Colom, L. Involucramiento de los actores relevantes en el proceso de evaluación de tecnología sanitarias 2017. https://www.htai.org/policy-forum/latin-america-policy-forum/ (accessed May 2, 2018).Google Scholar
18.Health Information and Quality Authority. Guidelines for Stakeholder Engagement in Health Technology Assessment in Ireland. Ireland, 2014. https://www.hiqa.ie/system/files/HTA-Guidelines-Stakeholder-Engagement.pdf (accessed May 2, 2018).Google Scholar
19.Chatham House Rule Londres, Reino Unido: Chatham House - The Royal Institute of International Affairs; 2016 [Septiembre 2016]. https://www.chathamhouse.org/about/chatham-house-rule (accessed May 2, 2018).Google Scholar