Insights and Implications an Analysis of the Studies Undertaken by HTAIn (Health Technology Assessment in India)
Author(s)
Varshini Neethi Mohan, B.E., PGDBM1, Rekha S, PhD2, V. R. Muraleedharan, PhD3.
1Research Scholar, IIT Madras, Chennai, India, 2Indian Institute of Science, Bengaluru, India, 3Indian Institute of Technology Madras, Chennai, India.
1Research Scholar, IIT Madras, Chennai, India, 2Indian Institute of Science, Bengaluru, India, 3Indian Institute of Technology Madras, Chennai, India.
OBJECTIVES: Health Technology Assessment sets explicit priorities to maximise health gains and support universal health coverage. Health Technology Assessment in India (HTAIn) was set up to ensure efficient allocation of public health expenditure impacting 1.4 billion Indians. We conducted an analysis to evaluate the methods used in the research undertaken by HTAIn thus far, identify gaps and recommend the way forward.
METHODS: We shortlisted 33 of the 39 studies published by HTAIn on their website in October 2023. We analysed diseases treated, types of interventions evaluated, aspects of HTA addressed, and whether the intervention was cost effective. The quality of each study was rated against Drummond’s checklist and the Indian Reference Case. Results were charted and tabulated where possible, and descriptive classifications and a critical appraisal of findings were set down.
RESULTS: 24.2% (n=8) of the studies focused on interventions for maternal and neonatal disorders, 33.3% (n=11) of the interventions were devices and 45.5% (n=15) were intended for screening. All addressed economic efficiency, 75.8% (n=25) evaluated clinical efficacy, and 54.5% (n=18) spoke of effectiveness; 45.5% (n=15) addressed all three. Against the Indian Reference Case, 6 studies scored above 8, and the rest scored between 4.55 and 7.95. Equity and heterogeneity (population subgroup analysis) are the parameters that fared worst. 84.8% (n=28) of interventions were cost-effective at a 1XGDP per capita threshold.
CONCLUSIONS: A formal framework for choosing interventions for evaluation would make the decision-making process explicit. While difficult to evaluate, operational feasibility, equity and heterogeneity need to be appraised to ensure that policy-makers draw considered conclusions. We recommend that a threshold specific to India be set to aid decision-making, and areas for disinvestment be identified, given health budget constraints.
METHODS: We shortlisted 33 of the 39 studies published by HTAIn on their website in October 2023. We analysed diseases treated, types of interventions evaluated, aspects of HTA addressed, and whether the intervention was cost effective. The quality of each study was rated against Drummond’s checklist and the Indian Reference Case. Results were charted and tabulated where possible, and descriptive classifications and a critical appraisal of findings were set down.
RESULTS: 24.2% (n=8) of the studies focused on interventions for maternal and neonatal disorders, 33.3% (n=11) of the interventions were devices and 45.5% (n=15) were intended for screening. All addressed economic efficiency, 75.8% (n=25) evaluated clinical efficacy, and 54.5% (n=18) spoke of effectiveness; 45.5% (n=15) addressed all three. Against the Indian Reference Case, 6 studies scored above 8, and the rest scored between 4.55 and 7.95. Equity and heterogeneity (population subgroup analysis) are the parameters that fared worst. 84.8% (n=28) of interventions were cost-effective at a 1XGDP per capita threshold.
CONCLUSIONS: A formal framework for choosing interventions for evaluation would make the decision-making process explicit. While difficult to evaluate, operational feasibility, equity and heterogeneity need to be appraised to ensure that policy-makers draw considered conclusions. We recommend that a threshold specific to India be set to aid decision-making, and areas for disinvestment be identified, given health budget constraints.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA202
Topic
Health Technology Assessment, Study Approaches
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas