Learning goals:
1. What is the traditonal TA? (types/perspecties/sensitiity analysis)
2. What is a mini- TA?
a. What are the pros and cons?
b. What are the diferences with the traditonal TA?
3. What is a budget impact analysis?
a. What are the pros and cons?
4. Just to think about: how can a (mini) TA infuence a budget impact analysis and iice iersa?
5. Apply to the case > what adiice would you giie Lara?
1. What is the traditonal TA? (types/perspecties/sensitiity analysis)
Lecture
ealth technology assessment ( TA): A multdisciplinary process that summarizes informaton about
the medical, social, economic, and ethical issues related to the use of health technology in a
systematc, transparent, unbiased, robust manner.
Gagnon: hospital-based health technology assessment
ealth technology assessment ( TA) is a multdisciplinary feld of applied research aimed at
providing high-quality informaton about the clinical efectieness or efcacy, cost-efectieness and
broader impact (including social and ethical implicatons) of health technologies (drugs, medical
technologies and health interientons) in order to support and inform those who make decisions
about health policy and purchasing, health seriices organizaton and management, and clinical
practces
Main driier TA: increased pressure to make more efcient use of scarce resources
Types
Case 5 – PI4001: ealth economics
Economic evaluatons
Costs Effects Decision making
CMA € 2 interientons with The analysis therefore focuses
almost similar efect on costs alone and the cheapest
opton is chosen
CBA € €
CEA € Natural units
CUA € QALY
CCA € not a formal method of economic eialuaton
Difficultes tradaditonal HTA
Lettieri – Priority setting for technology adopton at a hospital leiel
Priority setting for technology adapton at hospital leiel is largely oierlooked and wide
research eforts should be paid to this emerging issue.
Kidholm – assessment of the quality of mini- TA
Conductng normal TA is tme consuming
, Ehlers – doing mini-health technology assessments in hospitals
ard to incorporate TA in daily practce because of the long tmeliness of the TA
Lecture
- Important barriers to the use of traditonal TA in a C organizaton
o TA methodology-related factors
Complexites of studies
Assumptons in economic eialuatons
Greater atenton to naton/regional leiel
Societal perspectie is C organizaton
TA neglects budget impact
Transferability of TA results among hospitals
Absence of hospital- TA guidelines
o Management-related factors
Budgetary: constraint by resources
Access and tme constraints
ospital mangers report giiing greater importance to efectieness and
budgetary impact
Poor understanding of concepts, principles and methods
Lack of legal and regulatory factors low motiaton
2. What is a mini- TA?
a. What are the pros and cons?
b. What are the diferences with the traditonal TA?
Ehlers; Doing mini–health technology assessments in hospitals
Mini- TA is a management and decision support tool.
Mini- TA is defned as a form or checklists with seieral questons about prerequisites for and
consequences of using health technologies.
It includes twenty to thirty questons grouped according to the four TA perspecties:
o Technology
o Patent
o Organizaton
o Economy
Mini- TAs are used for assessment of all kinds of health technology.
The purpose of the form is to proiide a brief two-to fie-page basis for decisions about the
introducton of a specifc new health technology or a specifed change in the indicaton for
the use of existng technology.
Mini TAs are ofen performed by a single indiiidual, so they take less tme and costs than an
TA. Other health professionals, for example, nurses and fnancial managers, may also help
fll in the form, depending on the circumstances.
TA are always assessing a new technology by comparison with the existng technology at
the specifc hospital, and the mini- TA is only produced and submited if the hospital
considers the new technology benefcial to implement. oweier, this is implicit and not
stated explicitly in the TA reports.
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