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HTA – for better and worse Florian Berghea , MD. PhD. UMF “ Carol Davila” Bucharest

HTA – for better and worse Florian Berghea , MD. PhD. UMF “ Carol Davila” Bucharest berghea1@gmail.com 6 October 2011. A TRUE STORY…. Michael Drummond – one of the most preeminent voice in HTA. Best crash course in HE. HTA GENERATES UNHAPPY / ANGRY / AGGRESSIVE PEOPLES (UNFORTUNATELY).

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HTA – for better and worse Florian Berghea , MD. PhD. UMF “ Carol Davila” Bucharest

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  1. HTA – for better and worse Florian Berghea, MD. PhD. UMF “ Carol Davila” Bucharest berghea1@gmail.com 6 October 2011

  2. A TRUE STORY… Michael Drummond – one of the most preeminent voice in HTA Best crash course in HE

  3. HTA GENERATES UNHAPPY / ANGRY / AGGRESSIVE PEOPLES (UNFORTUNATELY)

  4. UNHAPPY / ANGRY / AGGRESSIVE PEOPLES OF HTA What makes them so? Possible solutions?

  5. What makes them so? Possible solutions? HTA process CONCLUSION

  6. Timing of hta • When is the right time for the assessment? • Should we rely on RCT / bioequivalence data or should we wait for real life data? (how about compliance?) • Should we use early data or should we wait for later results? effect Cohort 1 Cohort I1 5 years Cohort III 5 years time

  7. Hta criteria • Do we have enough clarity and consensus in our definitions of the criteria used when health technologies are valued? • Are we smart or wealthy enough to accept a societal perspective (how about the QoL and loss of working capacity)? • Could we avoid the conflict between Hospital perspective and those of Minister of health or Minister of Labor? • How about the patient – tax payer perspective?

  8. Hta and appeal process • Can an non-transparent process offer a real chance for a fair appeal? • How about the patient point of view? • Is this an appeal or a lobby?

  9. FRANCE, OUR OLDER SISTER…

  10. Hta and policy makers • Is the HTA a Sword or an Owl for Policy makers? • We can measure the expenses but how could we assess the morality of a decision? • How could we guarantee the real independence of HTA agency in a time when one main concern of stakeholders from the industry is related to the misuse of HTA ?

  11. Could we accept the mirror? • Is the 3rd payer ready to accept non-official data? • Do all departments from health technology companies sing the same song? • Could we incarcerate the local scientists (usually the best) involved in HTA in order to avoid any external influence?

  12. UNHAPPY / ANGRY / AGGRESSIVE PEOPLES OF HTA What makes them so? Possible solutions?

  13. Possible solutions? Conclusions / reflections • The process should be as transparent as possible • The involvement of different kind of stakeholders (industry, patients, medical doctors…) should be actively promoted • The HTA agency should be as independent as possible (including the financial independence of its members) and not made responsible for the subsequent political decision • It is wise to have clear rules in case of an appeal • and.. Don’t forget to educate the participants!

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