Moderator:
Joe Caputo, Founder & Managing Director, Vista Health Pte Ltd, Singapore
Expert speakers:
- Young Ae Jeong, Health Insurance Review & Assessment Service (HIRA), Wonju, South Korea
- Kavita Kachroo, BDS, MHA, Kalam Institute of Health Technology, Andhra Pradesh MedTech Zone, Andhra Pradesh, India
Hosted by ISPOR Asia Consortium as part of the ISPOR 2023 annual international conference, this Health Policy Update session featured two presentations highlighting important health policy trends for the Asia Pacific region. Expert speakers from India (Dr Kavita Kachroo) and South Korea (Young Ae Jeong) were invited to present and the panel was joined by ISPOR Global Member Engagement Director, Robert Selby. Also in attendance was Rob Abbott, ISPOR CEO and Executive Director. This is a brief summary report of the session which took place on May 9th, 2023.
EVIDENCE-BASED HEALTHCARE POLICY INITIATIVES - AN INDIAN PERSPECTIVE
Kavita Kachroo, BDS, MHA, Kalam Institute of Health Technology, Andhra Pradesh MedTech Zone, Andhra Pradesh, India
India’s HTA evolution and the role of Kalam Institute of Health Technology
India's healthcare industry is facing unprecedented challenges – the country is witnessing significant changes in its healthcare landscape, with growing demand for better availability, accessibility and affordability of quality healthcare services. To address these challenges, it is imperative to establish a robust, evidence-based healthcare policy framework.
The Kalam Institute of Health Technology (KIHT), named in honour of Dr APJ Abdul Kalam, the 11th President of India, has been established as a government project supported by the Department of Biotechnology. It is a unique institution globally, located in the Andhra Pradesh MedTech Zone (AMTZ), Vizag, which is the world's largest medical device research, development and manufacturing cluster.
Under the leadership of Dr Jitendra Sharma, the Institute’s Executive Director, India embarked on its journey to build Health Technology Assessment (HTA) capacity by initiating the International Fellowship on Health Technology Assessment program in December 2012. The importance of HTA was recognized in the 12th 5-Year National Plan in 2012, emphasizing its role in informed decision-making and resource allocation. In 2016, the Medical Technology Assessment Board received approval, laying the foundation for an official HTA body, which became operational in 2017, marking a significant milestone in India's HTA journey. HTA infrastructure was expanded with the creation of HTAIn and HTA Regional Resource hubs 2018, ensuring regional participation, accessibility, and localized support. In 2019, a HTA Bill was introduced, demonstrating a commitment to institutionalize HTA practices. Today HTA plays a pivotal role in India, shaping health policy and promoting efficient resource utilization.
India's evolution in HTA and the role of KIHT has been remarkable; KIHT is the world's only WHO Collaborating Centre for Health Innovation, and In November 2023 will host the World Health Innovation Forum at its AMTZ campus, in collaboration with Indian Council of Medical Research, Govt. of India and WHO Innovation Hub, Geneva.
For a full list of departments under KIHT, visit the KIHT website at https://kiht.in
Evidence-based national initiatives in India
India has launched numerous national initiatives aimed at enhancing healthcare accessibility, improving health outcomes, and ensuring affordability and efficiency in the healthcare system. These endeavours align with the mandate of the World Health Assembly to "Save lives, drive health for all," and uphold the principle that every individual should have access to the healthcare services they require.
Examples of evidence-based national initiatives in India include:
National Health Insurance:
The National Health Insurance program is a flagship initiative aimed at achieving universal health coverage (UHC), providing financial protection and access to healthcare for the poorest and most vulnerable sections of society. The program covers over 100 million families and offers free secondary and tertiary healthcare services worth up to INR 5 lakhs per family per year. This government-funded health insurance program is the world's largest and represents a significant step towards achieving Universal Health Coverage (UHC) in India.
National Free Diagnostic Initiative (NFDI):
Launched in 2020, the NFDI provides free diagnostic services to patients visiting public health facilities across India. It aims to improve healthcare service quality, ensure timely and accurate diagnosis, and reduce the burden of disease.
National Dialysis Programme (NDP):
To address the burden of end-stage renal disease (ESRD), the Government of India launched the NDP in 2016, offering free dialysis services to poor and vulnerable populations, enhancing access to healthcare for patients with ESRD.
Drug pricing:
HTA plays a significant role in determining the prices of drugs and medical devices in India, which are regulated by the National Pharmaceutical Pricing Authority (NPPA). Additionally, generic stores have improved healthcare access for those who cannot afford expensive branded medications by providing affordable medications to patients by offering generic versions of drugs at lower prices.
AMRIT Pharmacy:
Launched in 2015, the government-run AMRIT Pharmacy network offers affordable and high-quality cancer drugs to patients. It operates through retail pharmacies across India, providing discounts of up to 60% off the market price and making cancer treatment more accessible to patients from all economic backgrounds.
National Digital Health Mission:
This initiative aims to develop the necessary digital health infrastructure to bridge gaps among different healthcare stakeholders, promoting an integrated digital healthcare ecosystem in India.
Indian Costing Database (ICDB):
Established in 2016, the ICDB serves as a repository of cost and unit cost data for healthcare services in India. It promotes standardized and transparent methods for costing healthcare services and supports HTA in the country.
EuroQol-5 Dimension (EQ-5D) study:
The EuroQol Group conducted a study using the EQ-5D questionnaire to measure the quality of life of the Indian population. The data generated from this study can inform health policymaking and resource allocation decisions in India.
In the words of Dr APJ Abdul Kalam, "Healthcare should be considered a fundamental human right, and it is the responsibility of every government to ensure its availability and affordability." In working towards achieving this goal, evidence-based healthcare policy initiatives in India have made substantial progress in delivering quality healthcare services to the population. Nonetheless, there is still a considerable journey ahead in attaining universal health coverage and enhancing health outcomes for everyone. Continued efforts, guided by robust evidence and a commitment to equitable healthcare provision, will be essential in building a healthier and fairer society for all individuals.
REIMBURSEMENT OF DIGITAL HEALTH IN KOREA
Young Ae Jeong, Health Insurance Review & Assessment Service (HIRA), Wonju, South Korea
The bio-health industry is growing rapidly, owing to the shift in the healthcare paradigm of providing patient-centric services in addition to advances in digital and convergent technologies. The Korean government has introduced a fast-track Integrated Review and Assessment System (IRAS) for Artificial Intelligence (AI) and Digital Innovative Medical Devices, designed to improve patient access to promising new technologies, reduce financial burden and accelerate the development of clinically meaningful technologies.
Innovative Medical Devices (IMD) are applying advanced technologies that have excellent potential value, and high technology intensity that have significantly improved, or are expected to significantly improve, safety and effectiveness, such as AI, Virtual/Augmented Reality, Big Data Technology, Digital therapeutics, IoT/Biosensor-based Wearable etc.
IRAS allows IMD to enter the healthcare field as swiftly as possible, meaning that the medical device industry is compensated for its innovative value, whilst providing patients with a wide range of choices and easy access to the innovative diagnostic and therapeutic services.
Nine AI-based technologies and Digital therapeutics (DTx) were announced for inclusion in IRAS. HIRA is developing guidelines on reimbursement for temporary listing, and plans to monitor the usage, patient compliance with DTx, market price, financial expenditures and clinical outcomes for 3~5 years. The final price and co-payment rate will be based on monitoring results, cost-effectiveness, clinical outcomes, etc. only if proven clinical effectiveness.
The full presentation recording of this session may be viewed in the ISPOR HEOR Learning Lab.
For more information about ISPOR Asia Consortium and ISPOR Asia Pacific focused initiatives, please contact
globalgroups@ispor.org.