Health Technology Assessment The Singapore Experience

NIHA Brainstorming Meeting on Secondary Research 7 February 2012

Dr Pwee Keng Ho Deputy Director (Health Technology Assessment) Ministry of Health, Singapore

Welcome to Singapore! • Who we are • Health Technology Assessment • HTA in MOH, Singapore

Who We Are

Who we are • Total population = 5 million • Singapore residents = 3.8 million 74.1% Chinese, 13.4% Malay, 9.2% Indians, 3.3% Others • Median age = 38 years

712 sq km

42 km

23 km

2010 & 2011 figures

Who we are Life expectancy: males = 79.3 yrs, females = 84.1 yrs Infant Mortality Rate = 2.0 per 1000 live births Maternal Mortality Ratio = 3 per 100,000 births Top 5 causes of death • Cancer • Ischaemic heart disease • Pneumonia • Cerebrovascular disease • Accidents, poisoning & violence

2010 figures

Who we are • Small country with few natural resources • Young population in good health • Developed country profile of diseases

Health Technology Assessment

Health Technology

Health technology is the application of scientific knowledge in health care and prevention.

• Medical devices • Drugs • Surgical procedures • Prevention • Rehabilitation • Health services & systems

i.e. any health intervention

Health Technology Assessment

Health technology assessment studies the medical, social, ethical and economic implications of development, diffusion, and the use of health technology and informs policy decisions. Its aim is to improve the quality and cost-effectiveness of healthcare.

~ NHS Centre for Reviews and Dissemination ~

Health Technology Assessment

Health technology assessment (HTA) is secondary research Methodologies in HTA • Systematic review • Economic evaluation

HTA in the MOH, Singapore

Ministry of Health Singapore

To ensure access to good and affordable healthcare that is appropriate to needs

To promote good health and reduce illness

To pursue medical excellence

Championing a healthy nation with our people

-- to live long, live well &

with peace of mind

Our Vision Our Mission

• Performs HTA to support MOH policy development and decision-making

• Manages MOH Clinical Practice Guidelines programme

• Promotes Evidence-Based Medicine

Health Technology Assessment Branch

• Rapid reviews

• Cost-effectiveness analyses

• Systematic reviews

• Clinical practice guideline (CPG) development

• Training on HTA and CPG development

Health Technology Assessment Branch

Rapid reviews • To support Health Service Development

Programme (HSD) applications

• To inform decisions and policy development for regulatory, financing or other purposes

Health Technology Assessment Branch

Cost-effectiveness analyses • Cost-effectiveness analyses of pneumococcal

vaccine and human papillomavirus vaccine

• Cost-effectiveness of universal MRSA screening compared to targeted screening

Health Technology Assessment Branch

Systematic reviews

• Reviews to identify key elements for integrated care pathways (e.g. hip fracture, stroke)

• Reviews to answer specific queries for integrated care pathways (e.g. COPD, DM)

Health Technology Assessment Branch

Clinical practice guideline (CPG) development

• 4 CPGs a year to support strategic initiatives by MOH policy divisions (e.g. CPGs for chronic diseases under CDMP)

• In addition to MOH CPG programme – AMS-MOH CPG programme, HPB-MOH CPGs, SAF-MOH CPG on heat injury

Health Technology Assessment Branch

Promotion of evidence based medicine

• Training workshops on HTA, CPG development, critical appraisal, etc.

• Organisation of conferences

Health Technology Assessment Branch

HTA capabilities • HTA branch, MOH • HSR units in public sector clusters • Statutory boards – Health Sciences Authority, Health Promotion Board • Academia – NUS-Duke Graduate Medical School

In conclusion • Singapore’s circumstances shape its policies •HTA informs public policy development and decision-making in the MOH • HTA capabilities are building up in various centres

Thank You