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Introducing health technology assessment in Tanzania

  • Gavin Surgey (a1) (a2), Kalipso Chalkidou (a3) (a4), William Reuben (a5), Fatima Suleman (a6), Jacqui Miot (a7) and Karen Hofman (a1)...

Abstract

Objectives

Health technology assessment (HTA) is a cost-effective resource allocation tool in healthcare decision-making processes; however, its use is limited in low-income settings where countries fall short on both absorptive and technical capacity. This paper describes the journey of the introduction of HTA into decision-making processes through a case study revising the National Essential Medicines List (NEMLIT) in Tanzania. It draws lessons on establishing and strengthening transparent priority-setting processes, particularly in sub-Saharan Africa.

Methods

The concept of HTA was introduced in Tanzania through revision of the NEMLIT by identifying a process for using HTA criteria and evidence-informed decision making. Training was given on using economic evidence for decision making, which was then put into practice for medicine selection for the NEMLIT. During the revision process, capacity-building workshops were held with reinforcing messages on HTA.

Results

Between the period 2014 and 2018, HTA was introduced in Tanzania with a formal HTA committee being established and inaugurated followed by the successful completion and adoption of HTA into the NEMLIT revision process by the end of 2017. Consequently, the country is in the process of institutionalizing HTA for decision making and priority setting.

Conclusion

While the introduction of HTA process is country-specific, key lessons emerge that can provide an example to stakeholders in other low- and middle-income countries (LMICs) wishing to introduce priority-setting processes into health decision making.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Gavin Surgey, E-mail: gsurgey@gmail.com

References

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1.Chalkidou, K, Glassman, A, Marten, R et al. (2016) Priority-setting for achieving universal health coverage. Bull World Health Org.. 94(6), 462–7.
2.Chalkidou, K, Levine, R, Dillon, A (2010) Helping poorer countries make locally informed health decisions. BMJ. 341, c3651.
3.Li, R, Ruiz, F, Culyer, AJ, Chalkidou, K, Hofman, KJ (2017) Evidence-informed capacity building for setting health priorities in low- and middle-income countries: a framework and recommendations for further research. F1000Research 6, 231.
4.Sandelowski, M (2000) Focus on research methods: Whatever happened to qualitative description? Res Nurs Health. 23, 334340.
5.Data drawn from World Health Organisation's Global Health Expenditure Database (http://apps.who.int/nha/database/Key_Indicators/Index/en).
6.World Health Organization (2014) Noncommunicable diseases country profiles 2014.
7.Mori, AT, Macha, E, Surgey, G (2018) Policy and political environment for health technology assessment in Tanzania. Johannesburg: PRICELESS South Africa.
8.MoHCDGEC (2017) The National Health Policy 2017 (Draft). Dar es Salaam, The United Republic of Tanzania.
9.MoHCDGEC (2017) Standard operating procedure for reviewing the standard treatment guidelines and the national essential medicines list of Tanzania. Dar es Salaam: The United Republic of Tanzania.
10.Surgey, G, Mori, A, Macha, E, Hofman, K (2018) Competence and experience of the Tanzanian health technology assessment committee. Johannesburg: PRICELESS South Africa.
11.MoHaSW. National Health Policy 2007. Dar es Salaam, The United Republic of Tanzania.
12.MoHaSW (2015) Health sector strategic plan IV. Dar es Salaam, The United Republic of Tanzania.
13.The Danish National Board of Health (1996) National strategy for health technology assessment. Copenhagen, Denmark.
14.WHO Regional Office for Europe (1991) Health for All Targets: The Health Policy for Europe. Copenhagen, Denmark.
15.Access and Delivery Partnership (2018) Who we are. Available at: http://www.adphealth.org (accessed 31 January 2018).
16.Glassman, A, Chalkidou, K (2012) Priority-setting in health: building institutions for smarter public spending. Washington, DC: Center for Global Development.
17.Mori, AT, Kaale, EA, Ngalesoni, F, Norheim, OF, Robberstad, B (2014) The role of evidence in the decision-making process of selecting essential medicines in developing countries: the case of Tanzania. PLoS One. 9(1), e84824.
18.World Health Organization (2002) Promoting rational use of medicines: core components (No. WHO/EDM/2002.3). Geneva: World Health Organization.
19.IMS Institute for Healthcare (2015) Understanding the role and use of essential medicines lists. New Jersey, USA.
20.Kar, SS, Pradhan, HS, Mohanta, GP (2010) Concept of essential medicines and rational use in public health. Indian J Commun Med: Off Publ Indian Assoc Prevent Soc Med. 35(1), 10.
21.Ochalek, J, Revill, P, Manthalu, G et al. (2018) Supporting the development of a health benefits package in Malawi. BMJ Global Health. 3(2).
22.van den Bent, MJ, Klein, M, Smits, M et al. (2018) Bevacizumab and temozolomide in patients with first recurrence of WHO grade II and III glioma, without 1p/19q co-deletion (TAVAREC): a randomised controlled phase 2 EORTC trial. Lancet Oncol. 19(9), 1170–9.
23.MacQuilkan, K, Baker, P, Downey, L et al. (2018) Strengthening health technology assessment systems in the global south: a comparative analysis of the HTA journeys of China, India and South Africa. Global Health Action. 11(1), 1527556.
24.Richards, T (2018) China to set the bar high for new health technologies 2018. Available at: https://blogs.bmj.com/bmj/2018/11/06/tessa-richards-chinabar-high-new-health-technologies/ (accessed 1 December 2018).

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