Agència d’Avaluació de Tecnologiai Recerca Mèdiques (AATRM)
www.aatrm.net
Oriol Solà-Morales
"Collaboration between HTA agencies in practice : learningfrom actual experiences“
Brussels, 13 October 2010
Clients, users and the collaborationpossibilities for a HTA Agency
Usefulness of Research
Health Affairs, August 2009
Usefulness of Research
For Who ?
Clients & Users
• Clients
−Public & Private
−Competitive & Non-competitive
• Users
−Policy Makers (Macro Level)
−Hospital management (Meso Level)
−Physicians and other Healthcare professionals(Micro Level)
• Other constituencies
Private
(For Profit / Not For Profit)
DoH
Primary Health Care
Hospitals / Mental Care
MoH
Drugs & HT
Private Providers
Clients & Users
Population
Patients
No allocationresponsibility
Involving Stakeholders
Diffusion Dissemination
2 phases:
• From doing to letting you know
• From letting you know to doing together: Involvingstakeholders in HTA
• Scientific societies
• HealthCare Professionals
• General Public
• …
Doing Doing together
Pricing & Reimbursement
Registry Price Reimburement
Dru
gs
CabinetAutonomous
DoH
Prescription Only
Non prescription
/ OTC
Hospitals / Physicians
Pharmacies
Pharmacies OOP
PromoterAutonomous
DoH
MSyPS /
AEMPS
AEMPSD
evic
es
How ?
Collaboration Possibilities
• Bottom-up
−Based on individuals, not on institutions
−Not long-standing
−Informal
• Top down?
• Academic collaboration
−Out-placements
−In-house Training
• Sharing Research projects
Collaboration: examples
CPG Drugs DevicesEcon.Eval.
CAHTA (AATRM) + + + +
OSTEBA + X + +
AETS X X + X
S. Canario Salud X + + +
AETSA + + + +
Avalia T + X + X
IACS + X + X
Ag. Laín Entralgo + X + X
Collaboration: examples
• HTA Agencies Spain
−AVALIA (CPG Mood Disorders)
−Collaboration as external reviewers
• HTA Agencies International
−Diaphragm pacemakers
−Hyperbaric oxygen therapy
−RaCat
−FRAX Validation
• Hospital HTA Units
−Da Vinci robotic surgery
−Rh Negative screening
−HIFU
Professionals Database
• Updating
• Alternatives? LinkedIn, Facebook, …
Collaboration with clients (LOCAL)
• Drug Industry
• Development plans
• Appropriate positioning
• Device Industry
• When should the device be used?
• Indication framework
• Demonstration of real value
• Private Providers
• Setting indicators
• Implementing Guidelines
• Prospective data gathering
• Trial design
Facts about information
• Users employ 25% of their time searchingfor information
• 60% of the property rights / intellectualproperty of a company is caught in e-mails
-Storage Magazine
• IT organizations spend 80% of their budgeton maintenance.
- Gartner
Facts: Storage Capacity
Facts: Google ‘Cloud’ Features
Ideal Collaboration Framework(INTERNATIONAL)
• Evidence tables available
• Outcome measures and scales agreed
• Appropriate incentives set
−Economic
−Publication
• Updated ‘in-progress’ listings
−Search engine?
−Automatic update?
Future Collaboration Possibilities
• Top-Down
−Requires regular funding & institutionalCommitment
• Building incentives for collaboration
−Direct payments for non-collaborating HTA
−External funding for up-to-date informationon development plans
• Contracts
• Strategic plan Specialisation
Areas of interest
Thank-you!