Criteria for assessment of new technologies at the hospital level (mini-HTA) and the national level (HTA)
HTAi 2012 Bilbao, June 25th 2012 Criteria for assessment of new technologies at the hospital level (mini-HTA) and the national level (HTA)Helene Arentz-Hansen, Senior researcher PhD, Norwegian Knowledge Centre for the Health Services
The Norwegian health system Northern Norway RHA Population: 5 millions 4 Regional Health Authorities (RHA) 27 Local Health Authorities Central Norway RHA Western Norway RHA South-Eastern Norway RHA
National system for evaluation of new technologies in the specialist health servicesReasons: Unequal practices for decision-making processes around introduction of new technologies into the health care system Ensure equal access to established treatment Ensure reasonable use of health resources A need for evidence-based, systematic introduction of new technologies HTA and mini-HTA
HTA supports decision-making processes at the national level when introducing new technologies HTA-report PolicyClinical Assessing the Impact Nationalresearch literature assessment guidelines Clinical effectiveness Ethics Safety Legal aspects Clinical Cost-effectiveness Patient perspective practice etc. 22. oktober 2012
Mini-HTA will support decision-making processes when introducing new health technologies at the hospital level Mini-HTA PolicyClinical Assessing the Impact Nationalresearch literature assessment guidelines Clinical effectiveness Organisation Safety Ethics Clinical Costs practice Mini-HTA is performed locally and take a few days (~ 5 days) 22. oktober 2012
The Norwegian mini-HTA-formThe form is divided into 3 parts:Part 1: Completed by the proposer physician, nurse, head of department etc.Part 2: Completed by a peer reviewer An ”unbiased” person, for instance from another hospital Is the evaluation in part one performed satisfactorily?Part 3: Recommendation for decision-maker Head of the department, managing director etc. Should the new technology be introduced into the health service?
Mini-HTA-formPart 1: Completed by the proposerContent:1. About the new technology2. The evidence (effectiveness, safety)3. Ethics4. Organisation5. Costs6. Summary and conclusions
Criteria for using mini-HTA prior to introduction of new technologies in hospitals1. When should mini-HTA be used?2. When should mini-HTA not be used?
Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued) 1. When should mini-HTA be used? Uncertainty or disagreement regarding effectiveness or safety Ethical issues
Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued)2. When should mini-HTA not be used? A) The effectiveness and safety are known. No ethical issues. B) It is obvious that the evidence concerning effectiveness and safety is limited C) Type of technologies that should be evaluated at the national level Screening Highly specialised health care Drugs Health economic evaluations
How the results of the mini-HTA will be used as a basis for further decisions If the effectiveness, safety and costs of the new technology are acceptable The hospital can decide to introduce the new technology
How the results of the mini-HTA will be used as a basis for further decisions Uncertainty remains concerning effectiveness and safety Exceeding of financial or organisational limits Ethical considerations of general interest May lead to differences in services between hospitals Need for assessment of cost-effectiveness The decision concerning introduction of the new technology should be lifted to a regional or national level
Summary A new system for evaluation of new technologies in the Norwegian health service will be introduced in 2012 This system is based on Health Technology Assessment as basis for decisions Mini-HTA at the local level HTA at the national level
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