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Criteria for assessment of new technologies at the hospital level (mini-HTA) and the national level (HTA)
HTAi 2012Bilbao, June 25th 2012
Helene Arentz-Hansen, Senior researcher PhD, Norwegian Knowledge Centre for the Health Services
Population: 5 millions
4 Regional Health Authorities (RHA)
27 Local Health Authorities
Northern Norway RHA
Central Norway RHA
Western Norway RHA
South-Eastern Norway RHA
The Norwegian health system
National system for evaluation of new technologies in the specialist health services
Reasons: Unequal practices for decision-making processes around
introduction of new technologies into the health care system
Ensure equal access to established treatment
Ensure reasonable use of health resources A need for evidence-based, systematic introduction of new
technologies
HTA and mini-HTA
10. april 2023
HTA supports decision-making processes at the national
level when introducing new technologies
Policy
National guidelines
Clinical practice
EthicsLegal aspectsPatient perspectiveetc.
HTA-report
Impact assessment
Clinical effectivenessSafetyCost-effectiveness
Assessing the literature
Clinical research
10. april 2023
Mini-HTA will support decision-making processes when
introducing new health technologies at the hospital level
Mini-HTA is performed locally and take a few days (~ 5 days)
Policy
Clinical practice
OrganisationEthicsCosts
Mini-HTA
Impact assessment
Clinical effectivenessSafety
Assessing the literature
Clinical research
National guidelines
The Norwegian mini-HTA-form
The form is divided into 3 parts:
Part 1: Completed by the proposer physician, nurse, head of department etc.
Part 2: Completed by a peer reviewer An ”unbiased” person, for instance from another hospital Is the evaluation in part one performed satisfactorily?
Part 3: Recommendation for decision-maker Head of the department, managing director etc. Should the new technology be introduced into the health service?
Mini-HTA-form
Content:
1. About the new technology
2. The evidence (effectiveness, safety)
3. Ethics
4. Organisation
5. Costs
6. Summary and conclusions
Part 1: Completed by the proposer
1. When should mini-HTA be used?
2. When should mini-HTA not be used?
Criteria for using mini-HTA prior to introduction of new technologies in hospitals
Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued)
1. When should mini-HTA be used?
Uncertainty or disagreement regarding effectiveness or safety
Ethical issues
2. When should mini-HTA not be used?
A) The effectiveness and safety are known. No ethical issues.
B) It is obvious that the evidence concerning effectiveness and safety is limited
C) Type of technologies that should be evaluated at the national level
Screening Highly specialised health care Drugs Health economic evaluations
Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued)
How the results of the mini-HTA will be used as a basis for further decisions
If the effectiveness, safety and costs of the new technology are acceptable
The hospital can decide to introduce the new technology
Uncertainty remains concerning effectiveness and safety Exceeding of financial or organisational limits Ethical considerations of general interest May lead to differences in services between hospitals Need for assessment of cost-effectiveness
The decision concerning introduction of the new technology should be
lifted to a regional or national level
How the results of the mini-HTA will be used as a basis for further decisions
The national mini-HTA-database
Summary
A new system for evaluation of new technologies in the Norwegian health service will be introduced in 2012
This system is based on Health Technology Assessment as basis for decisions
Mini-HTA at the local level
HTA at the national level