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Addressing Health System Values in Health Technology Assessment: The Use of Evidence-Informed Deliberative Processes

Published on Jan 1, 2019in International Journal of Technology Assessment in Health Care1.418
· DOI :10.1017/s0266462319000187
Wija Oortwijn11
Estimated H-index: 11
,
Philip Klein
Abstract
  • References (18)
  • Citations (0)
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References18
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#1Finn Børlum Kristensen (University of Southern Denmark)H-Index: 12
#2Don Husereau (U of O: University of Ottawa)H-Index: 20
Last. Allan Wailoo (University of Sheffield)H-Index: 30
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The systematic use of evidence to inform healthcare decisions, particularly health technology assessment (HTA), has gained increased recognition. HTA has become a standard policy tool for informing decision makers who must manage the entry and use of pharmaceuticals, medical devices, and other technologies (including complex interventions) within health systems, for example, through reimbursement and pricing. Despite increasing attention to HTA activities, there has been no attempt to comprehens...
5 CitationsSource
#1Bjørn Hofmann (University of Oslo)H-Index: 24
#2Ken Bond (Canadian Agency for Drugs and Technologies in Health)H-Index: 1
Last. Lars SandmanH-Index: 15
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Health technology assessment (HTA) is an evaluation of health technologies in terms of facts and evidence. However, the relationship between facts and values is still not clear in HTA. This is prob ...
2 CitationsSource
Background By tradition, the Swedish health care system is based on a representative and parliamentary form of government. Recently, new management forms, inspired by market principles, have developed. The steering system is both national and regional, in that self-governing county councils are responsible for the financing and provision of health care in different regions. National and local documents regulating Swedish health care mention several ethical values, such as equity in health for th...
2 CitationsSource
Health technology assessment (HTA) has over the past three decades become a well-established part of decisions about allocation of resources in many countries. Despite this, little is known about HTA’s impact on health systems. Few studies have evaluated the benefits of HTA for health outcomes, for access to care or for public budgets. In contrast, HTA has relatively clear upfront costs, which could potentially discourage policy-makers from establishing HTA agencies, especially in low income cou...
6 CitationsSource
#1Aris Angelis (LSE: London School of Economics and Political Science)H-Index: 11
#2Ansgar Lange (LSE: London School of Economics and Political Science)H-Index: 1
Last. Panos Kanavos (LSE: London School of Economics and Political Science)H-Index: 34
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Abstract Background Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. Objective To study the practices, processes and policies of value-assessment for new medicines acr...
30 CitationsSource
#1Wija Oortwijn (Ecorys)H-Index: 11
#2Domino Determann (Ecorys)H-Index: 1
Last. Jeroen van der Tuin (Ecorys)H-Index: 2
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Abstract Objectives To assess the level of comprehensiveness of health technology assessment (HTA) practices around the globe and to formulate recommendations for enhancing legitimacy and fairness of related decision-making processes. Methods To identify best practices, we developed an evaluation framework consisting of 13 criteria on the basis of the INTEGRATE-HTA model (integrative perspective on assessing health technologies) and the Accountability for Reasonableness framework (deliberative a...
8 CitationsSource
#1Tineke Kleinhout-Vliek (EUR: Erasmus University Rotterdam)H-Index: 1
#2Antoinette de Bont (EUR: Erasmus University Rotterdam)H-Index: 18
Last. Bert Boer (EUR: Erasmus University Rotterdam)H-Index: 2
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Policy makers and insurance companies decide on coverage of care by both calculating (cost-) effectiveness and assessing the necessity of coverage.
2 CitationsSource
#1Payam AbrishamiH-Index: 1
#2Wija Oortwijn (Ecorys)H-Index: 11
Last. Bjørn Hofmann (University of Oslo)H-Index: 24
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4 CitationsSource
#1Andrzej BieleckiH-Index: 13
#2Sylwia Nieszporska (Częstochowa University of Technology)H-Index: 2
The studies of health care systems are conducted intensively on various levels. They are important because the systems suffer from numerous pathologies. The health care is analyzed, first of all, in economic aspects but their functionality in the framework of systems theory is studied, as well. There are also attempts to work out some general values on which health care systems should be based. Nevertheless, the aforementioned studies, however, are fragmentary ones. In this paper holistic approa...
6 CitationsSource
#1Aris Angelis (LSE: London School of Economics and Political Science)H-Index: 11
#2Panos Kanavos (LSE: London School of Economics and Political Science)H-Index: 34
Last. Gilberto Montibeller (Lboro: Loughborough University)H-Index: 20
view all 3 authors...
A methodological approach is needed for allocating health care resources in an efficient and fair way that gives legitimacy to decisions. Currently, most priority setting approaches tend to focus on single or limited benefit dimensions, even though the value of new health care interventions is multi-dimensional. Explicit elicitation of social value trade-offs is usually not possible and decision-makers often adopt intuitive or heuristic modes for simplification purposes as part of an ad hoc deci...
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