Embracing well being expertise evaluation for medical units in MENA

There’s a progressive transfer in direction of value-based healthcare and the optimisation of healthcare budgets and spending within the Center East and Africa in addition to globally. This poses important challenges to the healthcare ecosystem.  

Though well being expertise evaluation (HTA) is mature and well-established within the pharmaceutical discipline, it’s nonetheless increasing within the discipline of medical expertise. Given this, Mecomed launched into a examine to discover the variations between HTA for prescription drugs and medical applied sciences. 

The examine consisted of a literature evaluate in addition to interviews with a number of trade stakeholders, policymakers, HTA companies within the Kingdom of Saudi Arabia, UAE, Egypt and international specialists. The trade respondents, with a median of twenty-two years of expertise, had been very educated in healthcare: 78 per cent have graduate and post-graduate {qualifications} in well being economics or associated topics.   

All through this examine, core themes emerged highlighting the distinctive parts of HTA for medical units. One such theme contains the distinction in proof technology. Typically, comparative effectiveness proof is missing for medical units at launch in comparison with the everyday part three proof gathered in medical trials of prescription drugs. Moreover, randomised managed trials usually are not performed for a lot of medical units. This poses the query: what proof may assist claims of efficacy, security, and high quality? This has been debated extensively in different areas of the world. One resolution features a versatile strategy in direction of proof technology utilizing real-world information (RWD).  

One other necessary distinction is the educational curve impact noticed in lots of medical units the place there’s a device-operator interplay. Generally, the operator (healthcare skilled) turns into more adept in performing procedures over time. For instance, theatre time for robotic surgical procedure would initially be longer because the operator builds expertise, nevertheless, over time, with improved proficiency, theatre time can be shorter than that of standard surgical procedure. The query then arises of how one ought to strategy this studying curve impact when performing financial modelling. One resolution is to observe a lifecycle strategy by contemplating the financial affect at completely different levels within the machine’s lifecycle. 

Incremental innovation is yet one more necessary distinction that must be thought of. Not all improvements in medical units are breakthrough improvements. Many are incremental improvements or small enhancements. This makes the product lifecycle very brief in comparison with prescription drugs. Typically these incremental improvements can’t be immediately attributed to well being outcomes as they is likely to be of profit to the operator. Given the excessive price of innovation in medical units, it’s not possible to do an HTA submission for every incremental innovation. 

 

Another necessary variations embody the dynamic pricing mechanisms seen in units (capital funding, rental, lease, and many others.) and the organisational affect of implementing some medical units in a facility (workers, area, and many others.). 

Total, the examine confirmed that there’s a important proof base supporting the challenges confronted in performing HTA for medical units. It’s crucial to work in direction of addressing the potential threat that HTA may create, giving an extra hurdle in guaranteeing entry to innovation to sufferers in want and guaranteeing that HTA is the device for enabling rewarding real-world innovation. Capability constructing and advancing the HTA information base for units ought to begin early, in any respect stakeholder ranges. This can pave the best way for constructive partnerships between HTA companies and trade.   

Proof from the examine additional highlights that one of many key attributes of profitable, mature HTA companies is their bias towards transparency, inclusiveness, communication, and procedural justice. This must be the purpose of all HTA companies. 

Collaboration at a regional and international degree with extra mature HTA companies is required to make sure that the adopted processes and insurance policies usually are not solely scientifically sturdy but additionally take into account particular person well being system realities.  

The examine confirmed that the units trade is numerous and faces distinctive challenges associated to HTA implementation and that important alternatives exist for collaboration between completely different stakeholders. One of many early imperatives will likely be to put money into the schooling of stakeholders to make sure the adoption of HTA insurance policies and processes that assist inhabitants well being outcomes. 

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Dr. Tienie Stander is the Managing Director of VI Analysis FZ LLC and Dr. Inna Nadelwais is the Government Director of MECOMED. 

 

This text seems within the newest situation of Omnia Well being Journal. Learn the total situation on-line at present.

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