Identification of publicly available data sources to inform the conduct of Health Technology Assessment in India

Abstract

Health technology assessment (HTA) provides a Background: globally-accepted and structured approach to synthesising evidence for cost and clinical effectiveness alongside ethical and equity considerations to inform evidence-based priorities. India is one of the most recent countries to formally commit to institutionalising HTA as an integral component of the heath resource allocation decision-making process. The effective conduct of HTA depends on the availability of reliable data.: We draw from our experience of collecting, synthesizing, and Methods analysing health-related datasets in India and internationally, to highlight the complex requirements for undertaking HTA, and explore the availability of such data in India. We first outlined each of the core data components required for the conduct of HTA, and their availability in India, drawing attention to where data can be accessed, and different ways in which researchers can overcome the challenges of missing or low quality data.: We grouped data into the following categories: clinical efficacy; cost; Results epidemiology; quality of life; service use/consumption; and equity. We identified numerous large local data sources containing epidemiological information. There was a marked absence of other locally-collected data necessary for informing HTA, particularly data relating to cost, service use, and quality of life.

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

“…These six data source domains encompass many of the key elements needed for a well-conducted economic evaluation, with context-relevant details specified ex ante based on a suitable reference case [21]. iDSI developed a reference case for adaptation to local situations [22] and it provides a systematic way to inform the conduct and reporting of economic evaluations.…”

“…We identified the information required to support HTA based on previous work from our group [21]. We focused on six 'data' domains, namely epidemiology, clinical efficacy, costs, health service use, quality of life and equity [21]. We identified data sources based on our local experience, using the internet to search the literature, Ghana government and other websites (e.g.…”

Beyond cost‐effectiveness: A five‐step framework for appraising the value of health technologies in Asia‐Pacific

“…We recommend that HTA agencies use best available estimates of the cost that a payer would incur in providing the medicine at scale in the main analysis (ie, base case), even if these prices are not currently available in the market. A good starting point for identifying these prices could be to use the tender prices obtained by large public hospitals, or government‐funded health insurance schemes if the drug is already available on the market, referencing the prices in neighboring countries or those with a similar setting or those of approved drugs with similar therapeutic effect . Where the resources exist to set up a formal pricing process, countries may also consider mandating that manufacturers submit a price proposal, which can then be used to inform CEAs…”

Estimating the Unit Costs of Healthcare Service Delivery in India: Addressing Information Gaps for Price Setting and Health Technology Assessment

“…Data on private expenditures are regularly collected by the National Sample Survey Office, but this is limited to patient expenditures on healthcare and cannot be broken down fully by disease or condition [7,8]. Insurance claims data from 22 different government-funded schemes have also been collated into a single database; however, these estimates reflect prices agreed by tender and do not represent the cost of production [7,9]. More recently, the availability of production cost data for the public sector has begun to grow with individual costing studies that have been carried out to explore the cost-effectiveness of different technologies as well as a series of primary costing studies [10][11][12][13][14][15][16][17][18][19].…”

“…More recently, the availability of production cost data for the public sector has begun to grow with individual costing studies that have been carried out to explore the cost-effectiveness of different technologies as well as a series of primary costing studies [10][11][12][13][14][15][16][17][18][19]. However, the paucity of cost information remains a significant fact within the Indian health system [7,20].…”