Health Technology Assessment Implementation in Ukraine: Current Status and Future Perspectives

Abstract

ObjectivesThe need for improving healthcare decision making by implementing health technology assessment (HTA) has been a top priority in Ukraine since 2016. This study sought to provide a tailor-made HTA implementation roadmap, drawing on insights from national stakeholders.MethodsWe conducted a survey using a questionnaire already applied in previous HTA research. We assessed the status of HTA when reforms were initiated in 2016 and examined perspectives on possible future developments among policy makers and representatives of pharmaceutical companies and patient organizations.ResultsThirty-two respondents answered the survey. Forty-eight percent of respondents were not aware of HTA training in Ukraine, but 91 percent preferred having either a graduate or postgraduate training. Experts stated that funding for HTA research and for critical appraisal of HTA submissions was limited, but in the future, they would increase funding mainly from public sources. A public HTA agency with academic support was the most preferred organizational structure. Eighty-eight percent of respondents opted for full transparency, making the HTA agency's recommendations and the related appraisal reports publicly available. A great majority of participants preferred mandating the use of local data in certain categories and indicated the importance of evaluating the transferability of international evidence. Healthcare priority and cost-effectiveness were the most important criteria for decisions, applied with a soft explicit threshold.ConclusionsUkraine is in the early phase of implementing HTA and our study provides a clear vision of national stakeholders about the future directions. In addition, learning from the experiences of other countries may help the implementation process.

Hybrid Closed-Loop Systems for the Treatment of Type 1 Diabetes: A Collaborative, Expert Group Position Statement for Clinical Use in Central and Eastern Europe

“…This is particularly pertinent for treatments for T1D-funding may not be present for novel technologies when the more affordable MDI therapy is the alternative, and when short-term financial drivers override longterm health economic benefits. While lack of funding represents the major problem in the region, nascent HTA agencies are also a hindrance in some Central and Eastern European countries, such as Romania and Ukraine-these agencies have less health economic expertise to draw from than their Western European counterparts, which have long-running and experienced HTA bodies in place [such as the National Institute for Health and Care Excellence (NICE) in England, the Haute Autorite ´de sante ´(HAS) in France, and the Institut fu ¨r Qualita ¨t und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) in Germany] [ [69][70][71][72]. Outdated and non-evidence-based eligibility criteria for novel therapies can prevent PwD receiving new, efficacious technologies, particularly if funding is instead diverted to medications at high prices with limited health gains [73][74][75][76].…”

Implementation Road Map of Health Technology Assessment in Middle-Income Countries: The Case of Jordan

“…A target sample size of 30 survey respondents (with a bare minimum of 20 respondents) was proposed based on adaptation of the same survey methodology in other countries. 18,19 Between June and November 2018, the survey was distributed to different stakeholders representing public and private sectors including Ministry of Health, Joint Procurement Department of Pharmaceuticals and Medical Supplies (JPD), Jordan Food and Drug Administration (JFDA), JRMS, Health Insurance Administration, university hospitals, the National HTA Committee, and pharmaceutical and medical device companies. The survey was distributed in electronic format through the network of co-authors.…”

The transferability of health technology assessment: the European perspective with focus on central and Eastern European countries

“…While for example Poland [15] and Hungary [16] have more than a decade-long experience with HTA institutions, several other Central and Eastern European countries are in less advanced stages of establishing HTA frameworks [17,18,19,20,21]. A limited tradition of transparency [22] and placing trust in independent institutions in CEE countries is a probable cause of an East-West divide in degree of HTA implementation and having evidence-based decision-making systems [8,23].…”