Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment

Abstract

This study reports the systematic development of a population‐based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence‐based manner that involved 41 stakeholders in a half‐day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta‐analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population‐based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X‐rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population‐based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision‐makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Foreword: Health Economic Evaluations in Low‐ and Middle‐income Countries: Methodological Issues and Challenges for Priority Setting

“…The experience of setting priorities in Thailand, an upper-middle-income country where formal stakeholder consultations and health technology assessments have been institutionalised in decision-making processes, is described by Teerawattannon and colleagues. The authors examine the case of defining a population-based health screening package for 12 leading health problems as part of the country's pursuit of universal health coverage (Teerawattananon et al, 2016). Theirs is an important example of how to incorporate local stakeholders' preferences into a process that recommends both disinvestment and investment and impacts decision-making.…”

Health Insurance Benefit Package in Iran: A Qualitative Policy Process Analysis

“…In France, for example, an independent organization has been established to regulate, facilitate and enhance the transparency of the HIBP and organize providers' compensation. A new treatment will only be accepted if it is proved to have higher bene ts (with the same level of costs) or lower costs (with the same level of bene ts) (7,17). It seems that the debates around developing policies and changing the steward of developing the HIBP are mostly focused on the source of nancing, while adequate attention has not been paid to how to develop the HIBP with targeting diseases/individuals.…”

Legislating for public accountability in universal health coverage, Thailand

“…28 Finally, stakeholders (policy-makers, medical experts, academia, research and innovation organizations, private industry, patient groups, civil society organizations and the general public) were able to participate in submissions of topics for consideration and the prioritization of new interventions included in the benefit package. [29][30][31][32][33][34]…”