Overview on the Current Implementation of Health Technology Assessment in the Healthcare System in Hungary

Németh, Bertalan; Csanádi, Marcell; Kaló, Zoltán

doi:10.1017/s0266462317000071

Cited by 12 publications

(11 citation statements)

References 12 publications

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“…Despite calls for increased openness of HTA as one of the founding principles of the field, in practice HTA can be associated with limited transparency and insufficient consultation with experts, manufacturers and patient organisations. Similar results were found in a recent overview on the HTA implementation in Hungary (Németh et al ., 2017). This raises obvious normative concerns and may, as in Hungary, contribute to a further diminishing of the HTA body’s role in pricing and reimbursement decision-making.…”

Section: Discussionmentioning

confidence: 99%

When health technology assessment is confidential and experts have no power: the case of Hungary

Csanádi

Löblová

Ozierański

et al. 2018

HEPL

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Health technology assessment (HTA) is not simply a mechanistic technical exercise as it takes place within a specific institutional context. Yet, we know little about how this context influences the operation of HTA and its ability to influence policy and practice. We seek to demonstrate the importance of considering institutional context, using a case study of Hungary, a country that has pioneered HTA in Central and Eastern Europe. We conducted 26 in-depth, semi-structured interviews with public- and private-sector stakeholders. We found that while the HTA Department, the Hungarian HTA organisation, fulfilled its formal role envisaged in the legislation, its potential for supporting evidence-based decision-making was not fully realised given the low levels of transparency and stakeholder engagement. Further, the Department's practical influence throughout the reimbursement process was perceived as being constrained by the payer and policy-makers, as well as its own limited organisational capacity. There was also scepticism as to whether the current operational form of the HTA process delivered 'good value for money'. Nevertheless, it still had a positive impact on the development of a broader institutional HTA infrastructure in Hungary. Our findings highlight the importance of considering institutional context in analysing the HTA function within health systems.

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Section: Discussionmentioning

confidence: 99%

When health technology assessment is confidential and experts have no power: the case of Hungary

Csanádi

Löblová

Ozierański

et al. 2018

HEPL

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“…EIP examples were identified in two fields, namely (1) in health technology assessment in the decision-making process of pharmaceuticals [ 25 ], and (2) in health system performance assessment [ 26 ] for which the first 2-year assessment cycle was completed in 2016. Other good practices mentioned were EU-funded public health projects, where community health promotion methods were grounded in systematic literature reviews, and national policies like the act on the protection of non-smokers [ 27 ], the introduction of public health product tax [ 28 , 29 ], the introduction of the trans-fatty acid decree, the public catering decree, or the human papillomavirus vaccination and screening initiative.…”

Section: Resultsmentioning

confidence: 99%

Qualitative assessment of opportunities and challenges to improve evidence-informed health policy-making in Hungary – an EVIPNet situation analysis pilot

Mihalicza

Leys

Borbás

et al. 2018

Health Res Policy Sys

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BackgroundIn evidence-informed policy-making (EIP), major knowledge gaps remain in understanding the context and possibilities for institutionalisation of knowledge translation. In 2014, the WHO Evidence-informed Policy Network (EVIPNet) Europe initiated a number of pilot countries, with Hungary among them, to engage in a ‘situation analysis’ (SA) in order to fill some of those gaps. This contribution discusses the results of the SA in Hungary on research–policy interactions, facilitating factors and potential barriers to establish a knowledge translation platform (KTP).MethodsIn line with the EVIPNet Europe SA Manual, a document analysis, 13 interviews, 3 focus group discussions with 21 participants, and an online survey with 31 respondents were carried out from April to October, 2015. A SA aims to assess the context in which EIP takes form and seeks opportunities to establish a KTP, so information was gathered on the current practice of EIP and knowledge translation, its relevant actors, enablers and barriers for EIP, and opinions on a future KTP. Methodological and researcher triangulation resulted in a narrative synthesis of data, including a comparison with literature. A stakeholder consultation was organised to validate findings.ResultsThis study reveals that stakeholders show commitment to produce and use research evidence in Hungarian health policy-making. All stakeholders endorsed the idea of strengthening the systematic use of evidence in decision-making and favoured the idea of establishing a KTP. In line with literature on other countries, some good practices exist on the uptake of evidence in policy-making; however, a systematic approach of developing, translating and using research evidence in health policy processes is lacking. EIP is currently hampered by scattered capacity, coordination problems, high fluctuation in government, an often legalistic and a more ‘symbolic’ rather than practical support for knowledge translation and EIP. The article summarises recommendations on a Hungarian KTP.ConclusionsPragmatic adaptation of the SA Manual to local needs proved to be a useful mechanism to provide insight into the Hungarian EIP field and the establishment of a potential KTP. Despite the success of a KTP pilot, it remains unclear how a KTP in Hungary will be institutionalised in a sustainable way.Electronic supplementary materialThe online version of this article (10.1186/s12961-018-0331-z) contains supplementary material, which is available to authorized users.

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“…This is because some aspects that are considered as barriers could be facilitators of change in other settings. For instance, Iran, Greece, and Singapore have successfully facilitated HTA institutionalization through an HTA unit within the MOH considering their existing policy and sufficient financing for HTA (15)(16)(17). On the other hand, considering the fragmented healthcare system in the UK, Germany, and some other countries, having an HTA unit within the MOH would be the primary barrier to introducing HTA-they need to have an independent HTA unit to better institutionalize HTA into their healthcare system and policy (8;11;13).…”

Section: Discussionmentioning

confidence: 99%

Exploring facilitators and barriers to introducing health technology assessment: a systematic review

Suharlim

Kumar

Salim

et al. 2021

Int J Technol Assess Health Care

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Objective This study aims to identify and codify the facilitators and barriers to help implementing partners institutionalize health technology assessment (HTA) successfully and navigate complex systems for health-related policy making. Methods We searched for peer-reviewed and gray literature articles examining HTA programs globally using six databases. Keywords used as a guide for capturing articles included “health technology assessment,” “barrier,” and “facilitator” and their synonyms. Search results were scrutinized for duplicates and screened through a review of titles and abstracts. A full-text review was conducted exploring articles’ coverage of twenty-seven evaluation criteria across four primary areas of interest: barriers/facilitators, motivations, guidelines, and institutional frameworks. Results A total of 18,599 records were identified for duplication check, title, and abstract review. A total of 1,594 articles underwent full-text review, leading to a final synthesis of 262 studies. We found that ninety-seven articles discussed barriers/facilitators, with fifty-three of those discussing local capacity and unavailable human resources. Out of the sixty-six articles discussing motivations, forty-two cited the interest in supporting the decision-making process for, and promoting, appropriate resource allocation. Of the sixty-one articles that discussed guidelines and institutional framework, twenty-one articles described HTA as an independent national unit, and sixteen described their HTA unit as a unit within the Ministry of Health (MOH). Conclusions This systematic review unpacks the dynamic and relevant contexts for understanding the HTA institutionalization process to help policy makers and practitioners achieve tangible progress in confronting the most critical issues facing priority setting and HTA institutionalization.

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Overview on the Current Implementation of Health Technology Assessment in the Healthcare System in Hungary

Cited by 12 publications

References 12 publications

When health technology assessment is confidential and experts have no power: the case of Hungary

When health technology assessment is confidential and experts have no power: the case of Hungary

Qualitative assessment of opportunities and challenges to improve evidence-informed health policy-making in Hungary – an EVIPNet situation analysis pilot

Exploring facilitators and barriers to introducing health technology assessment: a systematic review

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