Workshop The science and methodologies behind HTA, diversity and commonality across the EU

1. WorkshopThe science and methodologies behind HTA, diversity and commonality across the EU Achieving more patient centred HTA in different countries

2. Terminology • Patients • Citizens • Public • Service users • etc

3. Rationale for HTA • There are increasing expectations of what healthcare is available/provided • Increasing demands on available budgets • Decisions on what should be made available should be rational based on all available evidence

4. Health Technology Assessment (HTA) • HTA is a multidisciplinary process that summarises information about the medical, social, economic and ethical issuesrelated to the use of a health technology in a systematic, transparent, unbiased, robust manner

5. Different types of HTA • Assessment of available evidence to clarify the way a technology should be used • Assessment of available evidence to determine whether there is enough evidence to support the use of a technology • Assessment of available evidence of effectiveness and cost effectiveness to determine whether a technology offers value for money

6. Evidence used in HTA • Clinical trials • Efficacy • Quality of life • Economic evaluations • Modelling

7. Clinical trials • Get involved in the design of clinical trials so they measure what is important to patients • Ensure trial populations are broadly relevant • Help put the results of trials into the context of a patient’s life

8. Health related quality of life • Help develop and test QOL tools so they reflect what matters to patients • Try to ensure that disease specific tools are developed and validated • Reflect changes in priorities for patients at different stages of illness • Think about carers quality of life

9. Economic evaluations • Cost • Incremental cost effectiveness ratio (ICER) • Cost utility analysis • Cost per quality adjusted life year (QALY) • Disability adjusted life year (DALY)

10. How is patient evidence incorporated into HTA? • Patient input to trials • Patient input to assessment reports • Patient evidence • Reviewing recommendations • Making recommendations available in plain language

11. Challenges of involving patients in research • Challenges experienced by patients • Contribution hindered by difficulties with access and communication • Relationship (doctor supremacy, fear of preferential care) • Tokenism (political correctness) • Anxieties of new role – unclear about role and ability to contribute, perceived value of contribution, not appearing foolish, lack of familiarity with technical terms Hewlett et al, 2006

12. Patient evidence • Quantitative • Questionnaires/surveys • Patient Organisation databases • Qualitative • Individual interviews • Focus groups discussions and interviews • Futures workshops • Blogs, etc

13. Patient perspective • Use research that is • – well planned and structured • – systematic • – reported clearly showing sources, methods, potential biases, assumptions and findings

14. 3 fundamental issues affecting theme

15. 3 core recommendations