HOSPITAL BASED HEALTH TECHNOLOGY ASSESSMENT (HB-HTA) GLOBAL EXPERIENCE-: FRAMEWORK AND IMPLEMENTATION

OBJECTIVES

: Hospital Based Health Technology Assessment (HB-HTA) is used as a tool to optimize the efficiency of health care delivery. Existing HTA frameworks are designed to align with payer perspectives, and there is little consensus regarding best practices for HB-HTA. However, multiple proposals on HB-HTA methodologies and some case studies have been published. Here we summarize global HB-HTA experience and highlight the key success factors for performing HB-HTA, identified through systematic literature review.

METHODS

: Systematic literature searches were conducted using EMBASE and Web of Science. Original research articles in English, published 2010-2019 were extracted, excluding review articles and meeting abstracts. Following 2 rounds of independent abstract review a final selection of full-text articles was identified. Key information was stored in a database for descriptive analysis and qualitative comparisons.

RESULTS

: A total of 130 abstracts were identified, with 33 original articles retained for review, all published in 2013 or later. The majori9ty of articles were from 3 countries, Italy (13), Canada (7) and France (6). Twenty-two articles were methodology focused and 11 were case studies. Seven studies evaluated the impact of implementing HB-HTA programs, and the obstacles identified during the process, with 4 reporting the assessment of a new technology. The majority of HB-HTA focused on medical devices. HB-HTA methodologies included multi-stakeholder engagement, multi-criteria decision analysis, ambassador model, mini-HTA, and discrete choice models. Recommendations emphasized the importance of considering local context and the multi-dimensional aspects of HB-HTA. Challenges were identified in the implementation of decisions based on HB-HTA, including lack of expertise, knowledge gaps and insufficient collaboration.

CONCLUSIONS

: HB-HTA is becoming an important tool for hospitals to improve efficiency and manage enterprise risk. Global experience and research consensus suggest that a successful HB-HTA framework must incorporate a multi-criteria decision process capable of supporting the viewpoints of multiple stakeholders in the context of the local environment.