RELATION BETWEEN POLISH HTA RECOMMENDATIONS AND REIMBURSEMENT DECISIONS

Author(s)

Kawalec P1, Malinowski K1, Stawowczyk E2
1Jagiellonian University Medical College Institute of Public Health, Kraków, Poland, 2Statsoft Poland Sp z o.o., Kraków, Poland

OBJECTIVES:  The aim of the study was to assess the influence of public advisory bodies (the Transparency Council, the President of the AOTMiT; The Polish Agency for Health Technology Assessment and Tarff System) involved in the process on final reimbursement decisions performed by the Ministry of Health. METHODS:  We have analyzed all statements, recommendations and final reimbursement decisions in Poland for the period of two years: 2014 and 2015. For each recommendation we collected data on decisions as well as potential additional requirements regarding the reimbursement; data was presented for the whole analyzed period and separately for each year, to assess the general tendencies in the reimbursement decision-making in Poland. The tau Kendall measurement of agreement was used to assess the compliance between statements, recommendations and reimbursement decisions. RESULTS:  We collected 187 records, including 183 Transparency Board statements and 186 recommendations by the President of the AOTMiT, of which 74% and 79%, respectively in the year 2014 and 55% and 42%, respectively in the year 2015, were positive. The President of the AOTMiT was compliant with the statement of the Transparency Board in 95% of cases in the year 2014 and in 76% of cases in the year 2015. Of all drugs, 44% have already gained a positive reimbursement decision (53% in 2014 and 33% in 2015). Agreement between the recommendation and reimbursement status was 0.3188, which represents only moderate agreement. 24% of drugs with negative recommendation obtained positive final reimbursement decision. CONCLUSIONS:  We observed that final reimbursement decisions did not reflect statements and recommendations issued by the advisory boards. Positive recommendations issued by the AOTMiT did not guarantee positive reimbursement status, and negative recommendations in some cases did not result in the lack of reimbursement.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PHP163

Topic

Health Policy & Regulatory, Health Technology Assessment

Topic Subcategory

Decision & Deliberative Processes, Reimbursement & Access Policy

Disease

Multiple Diseases

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