Table 2

Aggregated results of valid responses from HTA implementation survey (scorecard)

ConsentYesNo
n (%)n (%)
Hereby, I accept that my anonymous answers can be aggregated and used in scientific presentations and publications21 (100%)0 (0%)
QuestionCurrent statusPreferred status
n (%)n (%)
1. HTA capacity-building
a) Education
No training5 (23.8%)0 (0.0%)
Project-based training and short courses16 (76.2%)0 (0.0%)
Permanent graduate program with short courses0 (0.0%)7 (33.3%)
Permanent graduate and postgraduate program with short courses0 (0.0%)14 (66.7%)
2. HTA funding
a) Financing critical appraisal of technology assessment
No funding for critical appraisal of technology assessment reports or submissions17 (85.0%)1 (4.8%)
Dominantly private funding (e.g. submission fees) by manufacturers for the critical appraisal of technology assessment reports or submissions3 (15.0%)9 (42.9%)
Dominantly public funding for critical appraisal of technology assessment reports or submissions0 (0.0%)11 (52.4%)
b) Financing health technology assessment (i.e. HTA research)
No public funding for technology assessment; private funding is not needed or expected17 (81.0%)1 (4.8%)
No or marginal public funding for research in HTA; private funding is expected4 (19.0%)0 (0.0%)
Sufficient public funding for research in HTA; private funding is also expected0 (0.0%)12 (57.1%)
HTA research is dominantly funded from public resources0 (0.0%)8 (38.1%)
3. Legislation on HTA
a) Legislation on the role of the HTA process and recommendations in the decision-making process
No formal role of HTA in decision-making11 (52.4%)1 (4.8%)
Dominantly international HTA evidence is taken into account in decision-making9 (42.9%)0 (0.0%)
International and additionally local HTA evidence is taken into account in decision-making1 (4.8%)10 (47.6%)
Local HTA evidence is mandatory in decision-making0 (0.0%)10 (47.6%)
b) Legislation on organizational structure for HTA appraisal
There is no public committee or institute for the appraisal process14 (66.7%)1 (4.8%)
A committee is appointed for the appraisal process5 (23.8%)0 (0.0%)
The committee is appointed for the appraisal process with the support of academic centers and independent expert groups1 (4.8%)2 (9.5%)
A public HTA institute or agency is established to conduct a formal appraisal of HTA reports or submissions1 (4.8%)1 (4.8%)
Public HTA institute or agency is established to conduct a formal appraisal of HTA reports or submissions with the support of academic centers and independent expert groups0 (0.0%)8 (38.1%)
Several public HTA bodies are established without central coordination of their activities0 (0.0%)0 (0.0%)
Several public HTA bodies are established with central coordination of their activities0 (0.0%)9 (42.9%)
4. Scope of HTA implementation
a) Scope of technologies (multiple choice)
HTA is not applied to any health technologies11 (52.4%)1 (4.8%)
Pharmaceutical products10 (47.6%)17 (81.0%)
Medical devices3 (14.3%)18 (85.7%)
Prevention programs and technologies2 (9.5%)19 (90.5%)
Surgical interventions1 (4.8%)17 (81.0%)
Other scope of technologies0 (0.0%)3 (14.3%)
b) Depth of HTA use in pricing and/or reimbursement decision of health technologies
HTA is not applied to any health technologies12 (57.1%)1 (4.8%)
Only new technologies with significant budget impact7 (33.3%)0 (0.0%)
Only new technologies1 (4.8%)0 (0.0%)
New technologies + revision of previous pricing and reimbursement decisions1 (4.8%)20 (95.2%)
5. Decision criteria
a) Decision categories (multiple choice)
None of the below categories are applied6 (28.6%)0 (0.0%)
Unmet medical need4 (19.0%)11 (52.4%)
Healthcare priority4 (19.0%)12 (57.1%)
Assessment of therapeutic value5 (23.8%)15 (71.4%)
Cost-effectiveness8 (38.1%)17 (81.0%)
Budget impact7 (33.3%)17 (81.0%)
Other decision categories0 (0.0%)1 (4.8%)
b) Decision thresholds
Thresholds are not applied17 (81.0%)1 (4.8%)
Implicit thresholds are preferred3 (14.3%)3 (14.3%)
Explicit soft thresholds are applied in decisions1 (4.8%)12 (57.1%)
Explicit hard thresholds are applied in decisions0 (0.0%)5 (23.8%)
c) Multi-criteria decision analysis
No explicit multi criteria decision framework is applied20 (100.0%)1 (4.8%)
Explicit multi criteria decision framework is applied0 (0.0%)20 (95.2%)
6. Quality and transparency of HTA implementation
a) Quality elements of HTA implementation (multiple choice)
None of the below quality elements are applied18 (85.7%)1 (4.8%)
Published methodological guidelines for HTA/economic evaluation2 (9.5%)11 (52.4%)
Regular follow-up research on HTA recommendations1 (4.8%)7 (33.3%)
A checklist to conduct a formal appraisal of HTA reports or submissions exists but not available for public0 (0.0%)9 (42.9%)
A published checklist is applied to conduct a formal appraisal of HTA reports or submissions0 (0.0%)16 (76.2%)
b) Transparency of HTA in policy decisions
Technology assessment reports, critical appraisal and HTA recommendation are not published20 (95.2%)1 (4.8%)
HTA recommendation is published without details of technology assessment reports and critical appraisal1 (4.8%)1 (4.8%)
Transparent technology assessment reports, critical appraisals and HTA recommendations0 (0.0%)19 (90.5%)
c) Timeliness
HTA submission and issuing recommendation have no transparent timelines19 (95.0%)0 (0.0%)
HTA submissions are accepted/conducted following a transparent calendar, but issuing recommendation has no transparent timelines1 (5.0%)3 (14.3%)
HTA submissions are accepted continuously and issuing recommendation has transparent timelines0 (0.0%)18 (85.7%)
7. Use of local data
a) Requirement of using local data in technology assessment
No mandate to use local data14 (73.7%)1 (4.8%)
The mandate of using local data in certain categories without the need for assessing the transferability of international evidence4 (21.1%)3 (14.3%)
The mandate of using local data in certain categories with the need for assessing the transferability of international evidence1 (5.3%)17 (81.0%)
b) Access and availability of local data
Limited availability or accessibility to local real-world data15 (71.4%)0 (0.0%)
Up-to-date patient registries are available in certain disease areas, but payers’ databases are not accessible for HTA doers4 (19.0%)1 (4.8%)
Payers’ databases are accessible for HTA doers, patient registries are not available or accessible in the majority of disease areas0 (0.0%)3 (14.3%)
Up-to-date patient registries are available in certain disease areas and payers’ databases are accessible for HTA doers2 (9.5%)17 (81.0%)
8. International collaboration
a) international collaboration, joint work on HTA (joint assessment reports) and national/regional adaptation (reuse) (multiple choice)
No involvement in joint work; and no reuse of joint work or national/regional HTA documents from other countries19 (100.0%)1 (5.0%)
Active involvement in joint work (e.g. Eunet HTA Rapid REA, full Core HTA)0 (0.0%)5 (25.0%)
National/regional adaptation (reuse) of joint HTA documents0 (0.0%)7 (35.0%)
National/regional adaptation (reuse) of national/regional work performed by other HTA bodies in other countries0 (0.0%)18 (90.0%)
b) International HTA courses for continuous education on HTA
Limited interest in (1) developing/implementing of and (2) participating at international HTA courses18 (100.0%)1 (4.8%)
Interest only in regular participation at international HTA courses0 (0.0%)2 (9.5%)
High interest in (1) developing/implementing of and (2) participating at international HTA courses0 (0.0%)18 (85.7%)

Note(s): For single choice questions, each expert chose 1 of the available options for the current status and 1 of the options for preferred status. E.g. for question 1a: an expert chose “No training” in the current status and “Permanent graduate program with short courses” for the preferred status, this means he thinks there are currently no training programs, and he would prefer that in 10 years, there will be permanent graduate programs with short courses

For multiple choice questions, each expert can choose more than one option for the current and preferred status. E.g. for question 4a: an expert chose “pharmaceuticals” and “medical devices” in the current status and “pharmaceuticals”, “medical devices”, “prevention programs” and “surgical interventions” for the preferred status. This means that currently he thinks that HTA is done for medical devices and pharmaceuticals and in the future, he prefers HTA to be done to surgical interventions and prevention programs as well

Source(s): Authors work

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