Application of the HTA Core Model for complex evaluation of the effectiveness and quality of Radium-223 treatment in patients with metastatic castration resistant prostate cancer

Abstract

BackgroundHealth technology assessment (HTA) is currently one of the major challenges in assessing medical innovations and healthcare systems. In Europe, the European Network for Health Technology Assessment (EUnetHTA) has been aspiring to develop and implement standards for international sharing of HTA results and studies. Slovakia and many other EU countries do not have an established HTA system yet. This paper is focused on an exact description of the EUnetHTA Core Model individual domains applied to the process of selecting patients in the terminal stage of prostate cancer for Radium-223 treatment under particular conditions of the Institute of Nuclear and Molecular Medicine (INMM) in Košice, Slovakia.ResultsWe produced the first pilot HTA report using the HTA Core Model in Slovakia. The main objective was to collect all relevant information on the particular technology, and provide its summary to the interested stakeholders on one spot. Rather than applying detailed individual items, i.e. assessment elements and assessment element cards, we concentrated on the content of individual domains and tried to fill them with the best country, facility and intervention related data. The dataset consisted of 52 patients that finished the treatment in the period 2015–2017. The patients were carefully selected according to the Radium-223 producer’s criteria. Only 33 patients received the full therapy consisting of six applications; their average survival was 10.5 months from the application of the last dose.ConclusionsBased on the results of our analyzes, we recommended several changes to the INMM processes and patient follow-up checks during the treatment process in order to make the therapy more effective. The greatest benefit is expected after the implementation of a 68Ge/68Ga generator in 2018, as the selection of patients suitable for the Radium-223 treatment will improve. We showed that the HTA Core Model can be implemented in Slovakia, even under conditions of no formal HTA support or institutionalization.

The efficiency evaluation of public procurement of medical equipment

“…These evaluations represent the valuable findings for policymakers and to ensure a transparent public procurement system as well as for increasing its efficiency. It is also important to confront these results with many institutions that cover suppliers of medical devices and equipment and thus, to create innovative partnerships not only in public procurement processes but also in technological development as manufacturing innovators can provide valuable information for health technology assessment that should be closely linked to public procurement processes in the healthcare sector (Huculová, 2018;Kiselova Bilekova et al 2018;Zavadil et al 2020;Petruželka & Barták, 2019).…”

A health technology assessment of personalized nutrition interventions using the EUnetHTA HTA Core Model

“…Conducting an (early) HTA with the HTA Core Model offers advantages such as the identification of key assessment components of interventions, the provision of a structured analysis of (early) scientific evidence, and the highlight of existing gaps from which the recommendations for subsequent decision-making steps can be formulated (18). Despite these benefits, only a limited number of studies utilizing the HTA Core Model for HTA have been published in scientific journals (19)(20)(21), and none of them were conducted in the nutrition field. As we believe that assessing the PREVENTOMICS interventions with the HTA Core Model in the premarket phase can help to inform further development and potential implementation decisions, this study aimed to compare these interventions with nonpersonalized nutrition interventions for people with normal weight, overweight and obesity, on all of the domains found in the HTA Core Model.…”