Mapping of Health Technology Assessment in China: Progress and Challenges from a Nationwide Repeated Cross-Sectional Survey
Author(s)
Yi Yang, PhD1, Yue Suo, MS1, Yu Xia, PhD1, Shimeng Liu, PhD1, Jian Ming, MSc1, Hui Sun, MSc1, Yan Wei, PhD1, Kan Tian, MS2, Yingyao Chen, PhD1.
1Fudan University, Shanghai, China, 2Nanjing University of Chinese Medicine, Nanjing, China.
1Fudan University, Shanghai, China, 2Nanjing University of Chinese Medicine, Nanjing, China.
OBJECTIVES: Health technology assessment (HTA) has been widely integrated into health policymaking in China. We conducted a survey in 2016 to map China’s HTA development. In 2017, the introduction of HTA to the National Drug Reimbursement List (NRDL) adjustments marked the HTA’s official institutionalization and accelerated its development in China. Thus, we repeated the survey to re-map the new phase of HTA in China.
METHODS: This cross-sectional study surveyed Chinese HTA stakeholders in 2021, using convenience and snowball sampling methods. The survey, adapted from the “Mapping of HTA Instruments” tool, assessed eight domains of HTA development. Participants responded using dichotomous or Likert scale formats, scoring 146 points. Data were collected via Sojump, with pre-testing to ensure validity. Besides, descriptive analysis was conducted to compare findings across the two survey rounds.
RESULTS: A total of 471 valid responses were collected. The overall HTA development score increased in 2021 (76.36 vs. 86.84, p < 0.001). Significant improvements were observed in seven domains (p < 0.001) except the identification of health technologies domain, whose score declined from 2016 to 2021 (3.92 vs 3.66, p < 0.05). Besides, challenges also remain in the implementation (5.33/10) and appraisal (5.28/9) domains. Regarding the perception of HTA development across different stakeholders, industry professionals presented the highest score in institutionalization, while healthcare workers scored the highest in the remaining seven domains and the overall score. In contrast, policymakers and researchers reported lower scores across all domains, which reflects their conservative opinions in terms of HTA progress.
CONCLUSIONS: Despite significant improvement in HTA development in China from 2016 to 2021, our repeated survey revealed the remaining gaps in the identification of health technologies, implementation and appraisal domains. To tackle these challenges, China could develop corresponding strategies to further strengthen HTA development and enhance HTA’s contribution to evidence-based health policymaking.
METHODS: This cross-sectional study surveyed Chinese HTA stakeholders in 2021, using convenience and snowball sampling methods. The survey, adapted from the “Mapping of HTA Instruments” tool, assessed eight domains of HTA development. Participants responded using dichotomous or Likert scale formats, scoring 146 points. Data were collected via Sojump, with pre-testing to ensure validity. Besides, descriptive analysis was conducted to compare findings across the two survey rounds.
RESULTS: A total of 471 valid responses were collected. The overall HTA development score increased in 2021 (76.36 vs. 86.84, p < 0.001). Significant improvements were observed in seven domains (p < 0.001) except the identification of health technologies domain, whose score declined from 2016 to 2021 (3.92 vs 3.66, p < 0.05). Besides, challenges also remain in the implementation (5.33/10) and appraisal (5.28/9) domains. Regarding the perception of HTA development across different stakeholders, industry professionals presented the highest score in institutionalization, while healthcare workers scored the highest in the remaining seven domains and the overall score. In contrast, policymakers and researchers reported lower scores across all domains, which reflects their conservative opinions in terms of HTA progress.
CONCLUSIONS: Despite significant improvement in HTA development in China from 2016 to 2021, our repeated survey revealed the remaining gaps in the identification of health technologies, implementation and appraisal domains. To tackle these challenges, China could develop corresponding strategies to further strengthen HTA development and enhance HTA’s contribution to evidence-based health policymaking.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HTA98
Topic
Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas