Health technology performance assessment: real-world evidence for public healthcare sustainability

A Guerra Júnior, L Lemos, B Godman, M Bennie, C Osorio de Castro, J Alvares, A Heaney, C Vassallo, B Wettermark, G Benguria-Arrate, I Gutiérrez-Ibarluzea, VC Santos, C Petramale, F Acurico

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: Health technology financing is often based on randomized controlled trials (RCTs), which are often the same ones used for licensing. Since they are designed to show the best possible results with typically Phase III studies conducted under ideal and highly controlled conditions to seek high internal validity and maximize the chance of demonstrating clinical benefit, they often do not reflect likely effectiveness in routine clinical care. Consequently, it is not surprising that technologies do not always perform in real life in the same way as controlled conditions. Since financing (and price paid) decisions can be made with overestimated results, health authorities need to ask whether health systems achieve the results they expect when they choose to pay for a technology. The optimal way to answer this question is to assess the performance of financed technologies in real world settings. Health technology performance assessment (HTpA) refers to the systematic evaluation of the properties, effects, and/or impact of a health intervention or health technology in the real world to provide information for investment/ disinvestment decisions and clinical guideline updates. The objective is to describe the development and principal aspects of the Guideline for HTpA commissioned by the Brazilian Ministry of Health. Method: Extensive literature review, refinement with experts across countries and public consultation. Results: A comprehensive guideline was developed, which has been adopted by the Brazilian government. Conclusion: We believe the guideline, with its particular focus on disinvestment, along with the creation of a specific program for HTpA, will allow the institutionalization and continuous improvement of the scientific methods to use real world evidence to optimize available resources not only in Brazil but across countries.
LanguageEnglish
Pages279-287
Number of pages9
JournalInternational Journal of Technology Assessment in Health Care
Volume33
Issue number2
Early online date23 Jun 2017
DOIs
Publication statusE-pub ahead of print - 23 Jun 2017

Fingerprint

Biomedical Technology Assessment
Guidelines
Delivery of Health Care
Biomedical Technology
Health
Technology
Healthcare Financing
Institutionalization
Licensure
Brazil
Referral and Consultation
Randomized Controlled Trials

Keywords

  • technology assessment
  • biomedical observational studies
  • health policy
  • health information systems

Cite this

Guerra Júnior, A ; Lemos, L ; Godman, B ; Bennie, M ; Osorio de Castro, C ; Alvares, J ; Heaney, A ; Vassallo, C ; Wettermark, B ; Benguria-Arrate, G ; Gutiérrez-Ibarluzea, I ; Santos, VC ; Petramale, C ; Acurico, F. / Health technology performance assessment : real-world evidence for public healthcare sustainability . In: International Journal of Technology Assessment in Health Care. 2017 ; Vol. 33, No. 2. pp. 279-287.
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Guerra Júnior, A, Lemos, L, Godman, B, Bennie, M, Osorio de Castro, C, Alvares, J, Heaney, A, Vassallo, C, Wettermark, B, Benguria-Arrate, G, Gutiérrez-Ibarluzea, I, Santos, VC, Petramale, C & Acurico, F 2017, 'Health technology performance assessment: real-world evidence for public healthcare sustainability ' International Journal of Technology Assessment in Health Care, vol. 33, no. 2, pp. 279-287. https://doi.org/10.1017/S0266462317000423

Health technology performance assessment : real-world evidence for public healthcare sustainability . / Guerra Júnior, A; Lemos, L; Godman, B; Bennie, M; Osorio de Castro, C; Alvares, J; Heaney, A; Vassallo, C; Wettermark, B; Benguria-Arrate, G; Gutiérrez-Ibarluzea, I; Santos, VC; Petramale, C; Acurico, F.

In: International Journal of Technology Assessment in Health Care, Vol. 33, No. 2, 23.06.2017, p. 279-287.

Research output: Contribution to journalArticle

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T2 - International Journal of Technology Assessment in Health Care

AU - Guerra Júnior, A

AU - Lemos, L

AU - Godman, B

AU - Bennie, M

AU - Osorio de Castro, C

AU - Alvares, J

AU - Heaney, A

AU - Vassallo, C

AU - Wettermark, B

AU - Benguria-Arrate, G

AU - Gutiérrez-Ibarluzea, I

AU - Santos, VC

AU - Petramale, C

AU - Acurico, F

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N2 - Objective: Health technology financing is often based on randomized controlled trials (RCTs), which are often the same ones used for licensing. Since they are designed to show the best possible results with typically Phase III studies conducted under ideal and highly controlled conditions to seek high internal validity and maximize the chance of demonstrating clinical benefit, they often do not reflect likely effectiveness in routine clinical care. Consequently, it is not surprising that technologies do not always perform in real life in the same way as controlled conditions. Since financing (and price paid) decisions can be made with overestimated results, health authorities need to ask whether health systems achieve the results they expect when they choose to pay for a technology. The optimal way to answer this question is to assess the performance of financed technologies in real world settings. Health technology performance assessment (HTpA) refers to the systematic evaluation of the properties, effects, and/or impact of a health intervention or health technology in the real world to provide information for investment/ disinvestment decisions and clinical guideline updates. The objective is to describe the development and principal aspects of the Guideline for HTpA commissioned by the Brazilian Ministry of Health. Method: Extensive literature review, refinement with experts across countries and public consultation. Results: A comprehensive guideline was developed, which has been adopted by the Brazilian government. Conclusion: We believe the guideline, with its particular focus on disinvestment, along with the creation of a specific program for HTpA, will allow the institutionalization and continuous improvement of the scientific methods to use real world evidence to optimize available resources not only in Brazil but across countries.

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