Evaluating healthcare technologies

Health technology assessments (HTAs) can provide healthcare decision makers with accessible and evidence-based information that will guide decisions about deploying healthcare technologies such as drugs, medical and surgical procedures or devices, and the efficient allocation of finite healthcare resources, writes Martin Flattery.

Health technology assessments (HTAs) can provide healthcare decision makers with accessible and evidence-based information that will guide decisions about deploying healthcare technologies such as drugs, medical and surgical procedures or devices, and the efficient allocation of finite healthcare resources. These assessments will play a vital role in informing healthcare policy in the coming years. The primary audience for HTAs in Ireland is decision makers within the publicly-funded health and social care system. It is recognised that the findings of a HTA may also have implications for other stakeholders in the system. Stakeholders include patient groups, the general public, clinicians, other healthcare providers, academic groups and the manufacturing industry.

Martin Flattery
Martin Flattery

The Health Information and Quality Authority has launched for consultation, its third in a series of HTA guidelines – the evaluation of clinical effectiveness of healthcare technologies.   The clinical effectiveness of a technology is the ability of that technology to achieve a clinically significant impact on a patient’s health status – an example is the ability of a medicine to reduce the risk of a heart attack by lowering blood pressure.  These new draft guidelines on evaluating clinical effectiveness are intended to provide best practice recommendations to those who produce HTA reports for the Irish healthcare system (including the Authority itself, the National Centre for Pharmacoeconomics and other organisations) on the evaluation of the effectiveness of the technology.

These new draft guidelines on evaluating clinical effectiveness are intended to provide best practice recommendations to those who produce HTA reports for the Irish healthcare system (including the Authority itself, the National Centre for Pharmacoeconomics and other organisations) on the evaluation of the effectiveness of the technology

Higher quality HTA reports that are relevant to the Irish healthcare system will be produced if these guidelines are followed. In turn, decision makers can be more assured that the technologies that they are requested to fund do have a clinically significant impact on patients’ health. The effective distribution of increasingly scarce resources in healthcare is extremely important, and these guidelines therefore have an important role in delivering a better quality service to the public.

The publication of the Clinical Effectiveness guidelines follows the two earlier publications by the Authority of HTA guidelines which are aimed at producers of HTA reports. The economic evaluation guidelines are available at http://www.hiqa.ie/system/files/HTA_Economic_Guidelines_2010.pdf and the Budget Impact Analysis (BIA) guidelines at http://www.hiqa.ie/system/files/HTA_Guidelines_for_Budget_Impact_Analysis.pdf. The economic evaluation guidelines addressed both the cost of such health technologies and the health benefits associated with them.  In contrast, ‘budget impact analysis’ (BIA) has been defined as a tool to predict the potential additional financial impact of the use of a new technology in a healthcare system with finite resources.  The BIA guidance aims to ensure that healthcare interventions used in Ireland work for patients, are affordable, and are good value for money.

The development of this series of Clinical Effectiveness guidelines is informed by published literature and best international practice. Each of the guidelines in the series were and will continue to be developed by the Authority with technical input from the National Centre for Pharmacoeconomics and in consultation with its Scientific Advisory Group (SAG). Providing broad representation from key stakeholders in Irish healthcare, this group includes methodological experts from the field of HTA. The group provides ongoing advice and support to the Authority in its development of national HTA guidelines.

The draft Clinical Effectiveness guidelines are available at http://www.hiqa.ie/system/files/Draft-HTA-Clinical-Effectiveness-Guidelines.pdf. Details on how to give feedback on the consultation are available on the Authority’s website (www.hiqa.ie).

The final document will be published on HIQA’s website, and it will apply to HTAs being conducted by, or on behalf of the Authority, the National Centre for Pharmacoeconomics, the Department of Health, and the HSE.

Martin Flattery is Head of HTA Research and Planning, Health Information and Quality Authority.