HTA in the public health system Health Intervention and Technology Assessment Program

the national health security office (nhso), institutes , manages largest health plan in thailand (universal coverage scheme [uc]), initiated collaborative research , development project 2 independent research institutes – health intervention , technology assessment program , international health policy program – in 2009. aim of project develop optimal strategy development of uc benefit package, is, determine interventions should candidate public reimbursement. project named research development of health benefit package under universal health care coverage scheme, or known ucbp (see www.ucbp.net). project incorporates multiple-criteria decision analysis (mcda) , deliberative process , multi stakeholders’ involvement guide national-level priority setting in health care coverage decision. review documented experience of 7 health technology assessment organizations in canada, england , wales, united states, netherlands, germany, sweden , spain, use explicit process of priority setting. findings concluded these organizations consider multiple criteria, involved multiple stakeholders, , distinguish, in 1 way or another, 4 basic steps in priority setting process. these steps applied in thai setting , included. results of review adapted thai setting, resulting in 4 steps of explicit priority setting including: 1) nomination of interventions assessments, 2) selection of interventions assessment, 3) technology assessment of interventions, , 4) appraisal of interventions. since beginning of research project 119 topics have been proposed inclusion benefit package, 53 topics selected further research or hta analysis.

one of benefit packages revised through ucbp development of health screening package under universal health coverage in 2010. currently, 3 public insurance schemes in thailand offer different health screening packages. study designed response requests stakeholders including decision-makers , representatives general public, develop evidenced-based health screening package population ensure equitable access essential health screening under 3 schemes. results led advice against elements of current clinical practice, such annual chest x-rays , particular blood test (e.g. kidney function test), , indicated introduction of new population-based health screening programs, such chronic hepatitis b, provide substantial health , economic benefits thais. final results presented wide group of stakeholders, including decision-makers @ ministry of public health , public health insurance schemes, verify , validate findings , policy recommendations. package has been endorsed thai uhc benefit package committee implementation in fiscal year 2016.

thailand national list of essential medicines process flowchart.

in 1981, thailand’s national list of essential medicines created. subsequently, in 1983, subcommittee development of national list of essential medicines works in collaboration food , drug administration secretariat. in latter years, function of subcommittee became maintenance of optimal list of medicines, wherein criteria selection cost, safety, efficacy , effectiveness of drugs. in each of these criteria, subcommittee’s consider scientific evidence determine medicines included in list. twenty-eight specialist working groups undertake task of determining should on list informing price negotiations between manufacturers , nlem. increasingly, awareness , realization evidence required optimal coverage decisions involved analyses in cost-effectiveness fifth criterion. in 2009, health economics working group established under subcommittee. working group composed of health economists, representatives subcommittee, academics , representatives 3 health insurance schemes , working group secretariat. in process, hitap in collaboration food , drug administration involved secretariat of working group function generate procedures , assure quality of evidence provided. hewg prioritized requests based on burden of disease, risk life , financial burden on households posed condition , social consideration , commissions cost-effectiveness research non-profit agencies (like hitap).