Assessing technology clinical benefits

In the current economic climate, health technology assessment (HTA) plays a vital public-interest role. New clinical effectiveness guidelines published recently by HIQA can contribute to better technology assessment and thereby help deliver safer better healthcare to the public, writes Martin Flattery.

The ability to assess the clinical benefit to patients from health technologies has been made easier for healthcare managers and decision makers following the recent publication of new guidelines by the Health Information and Quality Authority.

Martin Flattery
Martin Flattery

Developed following consultation with key stakeholders, the Guidelines for Evaluating the Clinical Effectiveness of Health Technologies in Ireland provide direction on how to measure the ability of a healthcare technology to make a significant difference to a patient’s health status and set out guidance on how to evaluate the clinical effectiveness of this technology for the Irish health service.

The guidelines have been developed by the Authority with technical input from the National Centre for Pharmacoeconomics and in consultation with its Scientific Advisory Group. Providing broad representation from key stakeholders in Irish healthcare, this group includes methodological experts from the field of HTA. Consultation with stakeholders on compiling guidelines is an important part of HIQA’s work to deliver better understanding of health technology assessment and therefore help drive sustainable improvement in the quality and safety of healthcare in Ireland.

The Authority is recommending that these guidelines be applied to HTAs being conducted on all healthcare treatments, including medications, procedures, medical devices, and broader public health initiatives

The Authority is recommending that these guidelines be applied to HTAs being conducted on all healthcare treatments, including medications, procedures, medical devices, and broader public health initiatives. They are relevant to the assessment of both new and existing healthcare technologies. They apply therefore to HTAs being conducted by or for the Authority, the National Centre for Pharmacoeconomics, for the Department of Health, and for the HSE.

By applying the guidelines, decision makers can be more assured that the technology that they are requested to fund has a clinically significant impact on patient’s health and will be of greater benefit than the existing standard of care. The guidance will also support effective decision making around the allocation of funding for health technologies.

These guidelines are the third in a series of HTA guidelines published by the Authority, following guidelines on economic evaluation and guidelines on budget impact analysis. Collectively, these guidelines aim to promote best practice in the performance of HTA by all those who undertake this work on behalf of healthcare services in Ireland. The Economic Evaluation guidelines and the Budget Impact Analysis (BIA) guidelines can be downloaded from: http://www.hiqa.ie/healthcare/health-technology-assessment/guidelines.

The economic evaluation guidelines address 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.

By applying the guidelines, decision makers can be more assured that the technology that they are requested to fund has a clinically significant impact on patient’s health and will be of greater benefit than the existing standard of care

HIQA has a statutory remit to evaluate the clinical and cost-effectiveness of health technologies. Arising out of these evaluations the Authority provides advice to the Minister for Health and to the Health Service Executive (HSE).

The primary audience for health technology assessments (HTAs) conducted by the Authority is therefore decision makers within the publicly-funded healthcare system. It is also recognised that the findings of a HTA may have implications for other key stakeholders in the Irish healthcare system, including: patient groups, the general public, clinicians, other healthcare providers, academic groups and the manufacturing industry.

The HTA guidelines as a series provide an overview of the principles and methods used in assessing health technologies. They are intended as a guide for all those who are involved in the conduct or use of HTA in Ireland. The purpose of these is to promote the production of assessments that are timely, reliable, consistent and relevant to the needs of decision makers and key stakeholders in Ireland.

The Clinical Effectiveness guidelines have been published on www.hiqa.ie and are available to download from: http://www.hiqa.ie/publications/guidelines-evaluating-clinical-effectiveness-health-technologies-ireland.

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