Working on Clinical Practice Guidelines and HTA in resource limited - PowerPoint PPT Presentation

Working on Clinical Practice Guidelines and HTA in resource limited settings: experience from Eurasian Countries Prof d-r Elizabeta Zisovska

I • ,,Health care systems in Europe are largely N based on the principles of health as a human T right, on equitable access to health and health R services, quality of health care, on solidarity, O and on the active participation of society as a D whole. Because of the difficulties associated U with rising costs, it is today vital to translate C those ideals into achievements which are T quantifiable both in terms of health and of I expenditure; only with the help of such exact O information can one hope to develop N defensible policies which balance initiatives against resources .( Drugs and money-WHO ) ” •

I N • Rapid development in health technologies T affects health policies of countries. Thus R Governments try to provide high quality, O equal and accessible health care to public D while managing health care budgets. U C • Countries also contributed to the T regional/global development of HTA by I establishing networks according to their O mutual interest. N

• HTA helps evidence-informed policy decisions I N where we aim to gain more value with limited T resources. R O • Clinical practice guidelines are the D U knowledge tools that help clinicians and C patients make evidence-based health care T I decisions. O • Both needs to be developed in order to N ensure an evidence informed decision making ecosystem.

THE STRUCTURE OF THE PANEL DISCUSSION • short presentation of the outcomes and objectives of the joint activities of the countries belonging to the Euroasian Initiative • background of the Initiative • sharing experience between the panelists and audience • coming to some common impressions and conclusions

OUTCOMES AND OBJECTIVES • This panel will create a platform where experiences in Eurasian countries can be shared with the HTA society, especially important that some countries will have their first opportunity to attend HTAi annual meeting. • The panel will also allow audience to actively participate in the discussions which will increase interaction between different settings.

B Development of HTA in the last few decades A C has not been limited to Europe and North K America. Latin American and Asian G countries have invested in HTA and these R countries also contributed to the O U regional/global development of HTA by N establishing networks according to their D cultural and geographical proximity, or the commonality of systems.

Considering the actual global situation regarding permanent growth of health care B A expenditures especially in developing countries, C Eurasian HTA Forum note the importance of HTA K as a multidisciplinary activity that systematically G examines the safety, clinical efficacy and R effectiveness, cost-effectiveness, organizational O implications, social consequences as well as U N legal and ethical considerations of the D application of a health technology, no matter if it is related to a drug, medical device, clinical or surgical procedure.

introduction B Similarly, in 2015, Eurasian HTA Initiative was A established with the leadership of Turkish C Society of Evidence Based Medicine and K • ,,Health care systems in Europe are largely based on the principles of health G included the countries ranging from Balkans as a human right, on equitable access to health and health services, quality R to Central Asia that are thought to be new, of health care, on solidarity, and on the active participation of society as a O but promising for development of HTA. There whole. Because of the difficulties associated with rising costs, it is today U vital to translate those ideals into achievements which are quantifiable are 9 membercountries N both in terms of health and of expenditure; only with the help of such exact D information can one hope to develop defensible policies which balance initiatives against resources .( Drugs and money-WHO ) ” •

introduction • Interventions to improve use of HTA and B guidelines in the region became a A priority during members’ discussions. C K • Rapid development in health technologies affects health policies of countries. G • Both needs to be developed in order to Thus Goverments try to provide high quality, equal and accessible health care R to public while managing health care budgets. ensure an evidence informed decision- O • Countries also contributed to the regional/global development of HTA by making ecosystem. U establishing networks according to their cultural and geographical proximity, N or the commonality of systems. D • To what extent are these needs, was identified by deep analysis of the situation.

introduction THE AIM OF THE INITIATIVE • To improve HTA in the member countries. • HTA helps evidence-informed policy decisions where we aim to gain • The members conducted SWOT (strengths, weaknesses, more value with limited resources. opportunities, and threats) analysis in enhancement of evidence-informed decision making for the members, where infrastructure, legal framework and lack of • Clinical practice guidelines are the knowledge tools that help capacity were found to be three of the major common clinicians and patients make evidence-based health care decisions. weaknesses for evidence based decision-making. Both needs to be developed in order to ensure an evidence informed decision making ecosystem.

The structure of the panel • National/Regional interest in multinational collaboration of discussion S advancing EBM practices • Genuine interest to capacity building in EBM practices T • Availability of web-based resources R • World Health Assembly resolution on promoting HTA in the E countries • short presentation of the outcomes and objectives N • Existence of public health system (varying degree), G • • background of the Initiative Introduction of clinical practice guidelines (to at least some H degree) into the healthcare system, • sharing experience between the panelists and audience • Existing cross-border cooperation between most of the T • coming to some common impressions and conclusions member-countries of Eurasian network. S • Interest of Governments to provide targeted funding of the cheapest possible services/technologies with highest impact and durable results. Interventions to improve use of HTA and guidelines in the region became a priority in members’ discussions.

• Low number of educated health personnel with Outcomes and objectives adequate knowledge on critical appraisal and W EBM E • Lack of adequate number of certified/licensed A EBM/HTA courses across the countries • Absence/scarcity of EBM-related courses K • This panel will create a platform where experiences in Eurasian • Lack of regional expertise in the field N • Language barrier- the need for translations to countries can be shared with the HTA society, especially E local languages of common regional important that some countries will have their first opportunity S documents and vice versa. to attend HTAi annual meeting. S • Lack of legal framework for advancing EBM • Lack of enough willingness and use of HTA in E • The panel will also allow audience to actively participate in the decision making by relevant stakeholders S discussions which will increase interaction between different • Lack of patients’ awareness of EBM practices settings. and reluctance to take self-responsibility to participate in their treatment decisions •

O • Interest in capacity building background • Possibility of joint activities in terms of improving EBM P practices, with particular emphasis on HTAs P • Growing interest on EBM among health professionals O • Growing health expenditures, with a need to optimize use of available resources R • Potential for relevant information T • Possibility to organize webinars, open to all countries to • Development of HTA in the last few decades has not been selected EBM topics U • Global support from countries with well-established EBM limited to Europe and North America. Latin American and N systems Asian countries have invested in HTA and these countries also I • Existence of EBM associations in some countries in the region, as a triggering factor for the others T contributed to the regional/global development of HTA by • All partners are members of World Health Organization-Euro I establishing networks according to their cultural and • WHO supporting HTA to be involved in universal health coverage E geographical proximity, or the commonality of systems. • Increasing demand of evidence on health technologies by S patient organizations