3 - Health Technology Assessment

Question 1

How are the costs of healthcare being paid for?

Answer 1

• 69% public (provincial and territorial governments, other public sector)
• 31% private (out of pocket, private insurance)

Question 2

What is causing health care costs to increase?

Answer 2

• Aging population
• Increased utilization of health care system
• Better diagnosis of medical conditions
• Advancements in imaging technologies
• Expensive new drugs (biologics)
• Increased utilization of drugs

Question 3

Describe opportunity cost

Answer 3

• Decision to fund health is a decision to not fund another non-health program
• True/opportunity cost of funding a program is the cost of the most desirable program which must be forgone to finance the program

Question 4

What is the WHO definition of health technology?

Answer 4

The application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives

Question 5

Examples of health technologies

Answer 5

• Drugs
• Medical devices (pacemakers, insulin pumps)
• Diagnostic techniques
• Surgical procedures
• Telemedicine

Question 6

What is the CADTH definition of health technology assessment?

Answer 6

The process of systematically reviewing existing evidence and providing an evaluation of the effectiveness, cost-effectiveness and impact, both on pt health and on the health care system, of medical technology and its use

Question 7

What goes into health technology assessment?

Answer 7

• Clinical effectiveness
• Cost effectiveness
• Safety, potential harms
• Legal and ethical implications
• Effect on society
• Input from pt groups

Question 8

What is the goal of health technology assessment?

Answer 8

• Provide high quality essential services on the basis of efficacy, effectiveness, cost and social acceptability
• Improve health of population it serves
• Ultimate aim = potentiate the capacity of health system to reach its goals

Question 9

Who uses health technology assessment?

Answer 9

• Regulatory agencies –> to permit the commercial use of a drug, device of other regulated technology
• Payers (health care authorities, health plans, drug formularies) about technology coverage and reimbursement
• Hospitals, health authorities, group purchasing organizations
• Government health department officials about implementing public health programs
• Clinicians and patients (consumers) about the appropriate use of health care interventions
• Manufacturers
• Research agencies

Question 10

When is HTA particularly useful for decision making?

Answer 10

• A technology has high unit or aggregate costs
• Explicit trade-off decisions must be made in allocating resources among technologies
• Technology is highly complex, precedent setting, or involves significant uncertainty
• Proposed provision of a tx, diagnostic test, or medical equipment is innovative or controversial
• Established technology w/ significant variations in utilization and outcomes