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Health technology assessment: A comprehensive framework for evidence-based recommendations in Ontario

  • Ana P. Johnson (a1), Nancy J. Sikich (a2), Gerald Evans (a3), William Evans (a4), Mita Giacomini (a5), Murray Glendining (a6), Murray Krahn (a7), Les Levin (a8), Paul Oh (a9) and Charmaine Perera (a10)...
Abstract

Objectives: This study describes the development of a framework for health technology decisions, for Ontario Health Technology Advisory Committee (OHTAC) in Ontario, Canada.

Methods: OHTAC convened a “Decision Determinants Sub-Committee” in January 2007, which undertook a systematic literature review and conducted key informant interviews to develop an explicit decision-making framework.

Results: The “Decision Determinants Sub-Committee” offered recommendations about decision criteria, and the process by which decisions are made. Decision criteria include (i) overall clinical benefit, (ii) consistency with societal and ethical values, (iii) value for money, and (iv) feasibility of adoption into the health system. The decision process should be transparent and fair and should use a deliberative process in delivering recommendations.

Conclusions: This methodology is currently being pilot tested in a live environment: OHTAC. It will be evaluated and revised according to its feasibility, acceptability, and perceived usefulness.

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1. Aaron, HJ. Serious and unstable condition. Washington DC: The Brookings Institution; 1991.
2. Bodenheimer, T. High and rising health care costs. Part 2: Technologic innovation. Ann Inten Med. 2005;142:932937.
3. Borowski, HZ, Brehaut, J, Hailey, D. Linking evidence from health technology assessments to policy and decision making: The Alberta model. Int J Technol Assess Health Care. 2007;23:155161.
4. Chernew, ME, Hirth, RA, Sonnad, SS, Rrmann, R, Fendrick, AM. Managed care, medical technology, and health care cost growth: A review of the evidence. Med Care Res Rev. 1998;55:259288.
5. Culyer, AJ. NICE's use of cost-effectiveness as an exemplar of a deliberative process. Health Econ Policy Law. 2006;1:299318.
6. Daniels, N, Sabin, JE. Accountability for reasonableness. In: Daniels, N, Sabin, JE, eds. Setting limits fairly: Can we learn to share medical resources. New York: Oxford University Press; 2002:4366.
7. Daniels, N, Sabin, JE. Accountability for reasonableness: An Update. BMJ. 2008;337:a1850.
8. Erickson, LJ, De Wals, P, Farand, L. An analytical framework for immunization programs in Canada. Vaccine. 2005;23:24702476.
9. Fuchs, VR, Sox, HC Jr. Physicians' views of the relative importance of thirty medical innovations. Health Aff (Milwood). 2001;20:3042.
10. Garcia-Altes, A, Ondategui-Parra, S, Neumann, PJ. Cross-national comparison of technology assessment processes. Int J Technol Assess Health Care. 2004;20:300310.
11. Gelijins, A, Rosenberg, N. The dynamics of technological change in medicine. Health Aff (Milwood). 1994;13:2846.
12. Giacomini, M. One of these things is not like the others: The idea of precedence in health technology assessment and coverage decisions. Milbank Q. 2005;83:193223.
13. Giacomini, M. How good is good enough? Standards in policy decisions to cover new health technologies. Healthc Policy. 2007;3:91101.
14. Johnson-Masotti, AP, Eva, K. A Decision-making framework for the prioritization of health technologies. In: Beach, CM, Chaykowski, S, Shortt, S, St.-Hilaire, F, Sweetman, A, eds. Health services restructuring in Canada: New evidence and new directions. Kingston: John Deutsch Institute, Queen's University; 2006:5981.
15. Lehoux, P, Williams-Jones, B. Mapping the integration of social and ethical issues in health technology assessment. Int J Technol Assess Health Care. 2007;23:916.
16. Levin, L, Goeree, R, Sikich, N et al., Establishing a comprehensive continuum from an evidentiary base to policy development for health technologies: The Ontario experience. Int J Technol Assess Health Care. 2007;23:299309.
17. National Institute for Clinical Excellence TAT. Parallel sessions: NICE work. Technology appraisal guidance: An overview. J Clin Excell. 2002;4:350351.
18. Neumann, PJ, Palmer, MS, Daniels, N et al. , A strategic plan for integrating cost-effectiveness analysis into the US healthcare system. Am J Manag Care. 2008;14:185188.
19. Newhouse, JP. An iconoclastic view of health cost containment. Health Aff (Milwood). 1993;14:185188.
20. Noorani, HZ, Husereau, DR, Boudreau, R, Skidmore, B. Priority setting for health technology assessments: A systematic review of current practical approaches. Int J Technol Assess Health Care. 2007;23:310315.
21. PausJenssen, AM, Singer, PA, Detsdu, AS. Ontario's formulary committee: How recommendations are made. Pharmacoeconomics. 2003;21:285294.
22. Rawlins, MD. NICE work – providing guidance to the British National Health Service. N Engl J Med. 2004;351:13831385.
23. Royle, P, Waugh, N. Literature searching for clinical and cost-effectiveness studies used in health technology assessment reports carried out for the National Institutes for Clinical Excellence appraisal system. Health Technol Assess. 2003;7 (iii, ix–x):151.
24. Sackett, DL, Rosenberg, WMC, Gray, JAM, Haynes, RB, Richardson, WS. Evidence based medicine: What it is and what it isn't. BMJ. 1996;312:7172.
25. Visalakshi, S, Mohan, S. Evaluation of biotechnology-based healthcare products for prioritization in Indian context. Int J Technol Assess Health Care. 2002;18:718–227.
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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
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