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

Abstract

Background: Health technology assessment (HTA) provides a 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. Methods: We draw from our experience of collecting, synthesizing, and 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. Results: We grouped data into the following categories: clinical efficacy; cost; 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. Conclusions: The introduction of HTA into the health policy space in India provides an opportunity to comprehensively assess the availability and quality of health data capture across the country. While epidemiological information is routinely collected across India, other data inputs necessary for HTA are not readily available. This poses a significant bottleneck to the efficient generation and deployment of HTA into the health decision space. Overcoming these data gaps by strengthening the routine collection of comprehensive and verifiable health data will have important implications not only for embedding economic analyses into the priority setting process, but for strengthening the health system as a whole.

Implementing e–Upchaar: Hospital Management Information System for public health facilities in Haryana

“…In India, the implementation of HMIS is in a nascent stage and therefore, there is often a lack of useful quality data and inefficient utilization of resources (13). Downey et al emphasized that the lack of consistent and quality data (14) for planning and management of health services is a significant weakness of the health systems in our country (13). To tackle this problem, the Government of Haryana launched its flagship project to implement e-Upchaar (6) in the public health facilities of the state.…”

Mapping of Health Technology Assessment (HTA) teaching and training initiatives: Landscape for evidence-based policy decisions in India

“…Limited numbers of studies are available on economic efficacy, cost-effectiveness/benefits, system cost, public policy perspectives, and evidence data synthesis in India. [ 37 38 39 ] Health being a state subject drives the decision/implementation of health policies at the state level. Central government being primarily centralized in structure involves multiple stakeholders, who can also support states as a facilitator in medical education/managing regulatory bodies and other activities.…”

“…India has recently embarked on the journey of introducing HTA for evidence-based informed policy making. [ 30 31 32 33 34 35 36 37 38 39 ] Having widespread regional variations in health parameters across the country, it is going to be a herculean task to implement the results from HTA as a nationally representative figure.…”

“…Similarly, masters/diploma courses in public health, and hospital administration/management were also surveyed to locate the inclusion of HTA as a component in these courses. [ 38 ]…”

Building Capacity for Evidence-Informed Priority Setting in the Indian Health System: An International Collaborative Experience

“…In addition, we made a formal assessment of the availability and completeness of the evidence necessary to inform the conduct of HTA in India [ 30 ]. Local data requirements were outlined according to six domains (clinical effectiveness, cost, service use, equity, clinical epidemiology and quality of life).…”