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INTEGRATE-HTA: A LOW- AND MIDDLE-INCOME COUNTRY PERSPECTIVE

Published online by Cambridge University Press:  06 November 2017

Leon Bijlmakers Open the ORCID record for Leon Bijlmakers [Opens in a new window] ,
Debjani Mueller ,
Rabia Kahveci ,
Yingyao Chen  and
Gert Jan van der Wilt
Leon Bijlmakers
Affiliation:
Radboud University Medical Centre, Nijmegenleon.bijlmakers@radboudumc.nl
Debjani Mueller
Affiliation:
Charlotte Maxeke Research Cluster (CMeRC)
Rabia Kahveci
Affiliation:
Ankara Numune, Health Technology Assessment Unit (ANHTA)
Yingyao Chen
Affiliation:
Key Lab of Health Technology Assessment, School of Public Health, Fudan University
Gert Jan van der Wilt
Affiliation:
Radboud University Medical Centre
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Abstract

Objectives: The INTEGRATE-HTA project recommends that complexity be taken into account when conducting health technology assessments (HTAs) and suggests a five-step process for doing that. This study examines whether the approach suggested by INTEGRATE-HTA could be useful, appropriate, and feasible in the context of low- and middle-income countries (LMIC) given some of the typical challenges that healthcare systems face in those countries.

Methods: A nonexhaustive literature review was performed on the implementation in low and middle income countries of the five aspects recommended by the INTEGRATE-HTA project, using the following search terms: national health planning, health sector strategy, health sector performance, assessment criteria, health (management) information, complexity, context, stakeholder consultation.

Results: HTA is being practiced in LMIC in various ways and through different mechanisms, for example in health sector reviews, even though it is usually not referred to as HTA. It does not necessarily follow the five steps distinguished in the INTEGRATE-HTA model (scoping; defining the initial logic model; providing concepts and methods to identify, collect, and synthesize evidence in relation to various dimensions; extracting and presenting evidence in respect of agreed assessment criteria; providing guidance to draw conclusions and formulate recommendations).

Conclusions: The conditions for functional HTA are not always fulfilled in LMICs. At least four aspects would require special attention: (a) the scope and quality of routine health information that can support and be fed into health technology assessments and strategic planning; (b) consensus on health system performance assessment frameworks and their main criteria, in particular the inclusion of social disparities/equity and sustainability; (c) institutional capacity to set evidence-based priorities based on a variety of explicit criteria; (d) political will to engage with stakeholders in a transparent and inclusive consultation process about health priorities.

Keywords

Health technology assessmentPriority settingUniversal health coverage
Type
Theme Submissions
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 5: Assessing Health Technologies in an Integrated Way-Results of the INTEGRATE-HTA Project , 2017 , pp. 599 - 604
Copyright
Copyright © Cambridge University Press 2017 

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