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HTAi: A Global Collaboration Laura Sampietro-Colom, MD, PhD
Deputy Director Innovation. Hospital Clinic Barcelona
HTAi Immediate Past President
Index
1.Why a Global Collaboration in HTA?
2.What HTAi is?
3.HTAi and global collaboration in HTA
4.Final thoughts
Why a Global Collaboration in HTA?: 1rst
Shifting paradigmInnovation at any price
Innovation at value based reimbursement/price
“ You may consider yourself an individual, but I can tell
you that you are in a truth a cooperative community of
approximately fifty trillion single-celled citizens. Almost all
of your cells that make up your body are amoeba-like,
individual organisms that have evolved a cooperative
strategy for their mutual survival”
Lipthon B H, PhD (Cell biologists).
The Biology of Believe. 2008
Why a Global Collaboration in HTA?: 2nd
Survival depends on cooperation/ collaboration
• Regulatory agencies
• Governments
• Payers
• Providers
• Industry
• Patients
• Safety/efficacy/effectiveness
• Access to services
• Profitability
• High quality
• Cost containment
• Convenience
• Patient centeredness
• Satisfaction
Many stakeholders
Conflicting goals and incentives
Why a Global Collaboration?: 3rd
Localize decisions
1. The only interdisciplinar
international scientific &
professional society focusing
specifically in HTA
Meeting point
Building Together
What HTAi is?
3. Network for
Global thinking –
HTA diffusion &
Local action
Individuals
National/Federal Governments
Regional Governments
Insurance Companies
HealthTech industry
Hospitals
Primary care
HTA Agencies
What HTAi is?
• 52 Not-for-profit organizational members
• 16 For-profit organizational members
# of members/continent
Africa 7
Asia 86
Oceania 56
Europe 380
North America 222
South America 588
TOTAL MEMBERS 1339
HTAi:
The Scientific & Professional Society
Canada
U.S.A
Non-for-Profit Organizational Members = 52
HTAi:
The Scientific & Professional Society
U.K.
Germany
Spain
Non-for-Profit Organizational Members
HTAi:
The Scientific & Professional Society
Other European countries
HTAi:
The Scientific & Professional Society
Non-for-Profit Organizational Members
SPC on Standardization and HTA
Australia and New Zealand
Asia
HTAi:
The Scientific & Professional Society
Non-for-Profit Organizational Members
Europe: Clustering National HTA organizations
by their role in the assessment process
Perform the assessment and recommend (others take
final decision) (eg. SBU, DACEHTA, HAS, Spanish National &
Regional Agencies)
Perform a section of assessment (but own final report),
commission some sections, and recommend (others
take final decision) (eg. IQWiG, DAHTA, UVKL)
Mainly commission all the assessments and takes
decisions on coverage (eg. G-BA, NICE (MTA), AWSMG,
AIFA)
Industry perform the assessment, institutions check
the quality (redo model if needed) (eg. CVZ-CHT, TVL, SMC,
NICE (STA))
Europe: Weight of Clinical & Economic
outcomes in final recommendation
G-BA
IQWiG
CVZ
HAS
INCA
AIFA (up to now)
Clinical
NICE, SMC, AWMSG
SBU, TVL
Spanish Institutions
Regions
NICE, SMC,
AWMSG
CVZ (orientative)
Europe: Looking at economics
QALY based CEA
NICE, SMC, AWMSG
CVZ-CHT *
TVL
AIFA (recently)
BIA
UVKL
GB-A
HAS
Regions DK, Italy, Spain, Sweden
Hospitals (all)
Primary Care Trusts (UK)
Other economics
IQWiG * (CEA, recently)
GB-A (CEA, recently)
DACEHTA (CEA)
HAS (post-assessment
added value,post
launch)
Always
* If new treatment show
clinical added value
Sometimes
SBU (CUA, CEA, BIA)
DAHTA (BIA)
Spanish and Italian Regions (CEA)
For-Profit Organizational Members = 16
HTAi:
The Scientific & Professional Society
1. Annual Meetings
• Travel grants for Low and Middle income countries to Annual Meeting
• Educational grants for LMIC
• “Jill Sanders” Scholarship (Africa)
2. Travel & Educational Grants
HTAi & Global Collaboration in HTA
3. Interest Subgroups
• Early Career Network (launched 2011) 99 members
• Conditional coverage/access with evidence 247 members
• HTA in developing countries 98 members
• Disinvestment of obsolete or low added value 93 members
technologies
• Ethics in HTAi 44 members
• Hospital-based HTA 96 members
• HTA Regulatory Interactions (launched 2012) 4 members
• Information resources 179 members
• Patient and citizen involvement in HTA 148 members
HTAi & Global Collaboration in HTA
8. The HTAi Policy Forum– to facilitate productive interactions between
health care decision makers and industry
– to really bring industry, government and HTA
agencies working at the point of decision making
together.
– to have an open discussion of challenges so
that different perspectives and limitations can be
better understood
HTAi & Global Collaboration in HTA
Born in 2005 in London
Members 2012: Non-for profit=14 / For profit=14
Chatham House Rule
“When a meeting, or part thereof, is held under the
Chatham House Rule, participants are free to use the
information received, but neither the identity nor the
affiliation of the speaker(s), nor that of any other
participant, may be revealed.”
HTAi & Global Collaboration in HTA
8. The HTAi Policy Forum
8. The HTAi Policy Forum• Promoting Clinically Relevant Innovation and managing Uncertainty:
the role of the HTA process (6-7 Februry 2005, UK)
• Rethinking Regulation and HTA (5-7 February, 2006 Virginia, USA)
• Conditional Reimbursement / Coverage with Evidence (11-13 February
2007 , Zeist, Netherlands)
• Harmonizing Evidence Requirements for HTA in decision Making (10-12
February 2008, Rome, Italy)
• HTA for optimization of technology utilization (8-10 February, San
Francisco, USA)
• Managed Entry Schemes (31 January -2 February 2010, Washington
D.C., USA)
• HTA and Regulation (30 January-1 February 2011, London)
• HTA and disinvestment (San Francisco, 2012)
HTAi & Global Collaboration in HTA
9. MoU
Pre-conference meeting (2011)
Participation in plenary (2011)
1. Annual Meeting (after HTAi)
2. Joint ISG
3. Bidirectional Communication
with members
1. First Global Forum on
Medical Devices (MD)
2. Call for Innovative MD
3. Workshops at HTAi meeting
4. Web-casting developing
countries
52 members
26 countries
HTAi & Global Collaboration in HTA
ISG Emerging
Technologies
expected
10. HTA Glossary: HTAi, INAHTA, GIN, ISQUA
11. 1st Regional Meetings (LAC) (PAHO, Mercosur, MoH
Brazil and Argentina, IECS) (2010). 2nd expected 2012
12. Society for Medical Decision Making: Post-conference
½ day meeting (Nov. 2010), web-cast. Personalized
Medicine (2012)
13. Workshops with Regulatory Agencies (medicines and
Devices) (February & October 2011)
HTAi & Global Collaboration in HTA
14. Workshops with MoH (Argentina 2010, PAHO 2010, China
2011)
15. Promoting presence of HTA International networks in HTAi
Annual Meetings (EUnetHTA, INAHTA, EuroScan)
• Friendly and open-mind space for networking: Cross-fertilization
• Robust grounded space for discussion of:
– HTA methods practices and
– Health policy science regarding HTs
– Ways to implement HTA results into systems and clinical practices
• Dynamic an interactive space for evolving the science of both methods and health policy for a wise promotion (innovative) and recall (obsolete) HTs.
• Neutral place of dialog between those who produce HTA, those responsible for HTA based coverage and health care practice decisions, and industry.
What can HTAi offer in a global world?
Final thoughts
• International/Global collaboration as an
imperative today
• Highly needed for survival and evolution
• Background of HTAi is to promote and foster
global collaboration
• If you want to be part of the global HTA
community, HTAi is your place!