Health technology assessment in India: The potential for improved healthcare decision-making.
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Date
2014-05
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Abstract
Health technology assessment (HTA) is a multidisciplinary
approach that uses clinical effectiveness, cost-effectiveness, policy
and ethical perspectives to provide evidence upon which rational
decisions on the use of health technologies can be made. It can
be used for a single stand-alone technology (e.g. a drug, a device),
complex interventions (e.g. a rehabilitation service) and can also
be applied to individual patient care and to public health. It is a
tool for enabling the assessment and comparison of health technologies
using the same metric of cost-effectiveness. This process
benefits the patient, the health service, the healthcare payer and
the technology producer as only technologies that are considered
cost-effective are promoted for widespread use. This leads to
greater use of effective technologies and greater health gain. The
decision-making process in healthcare in India is complex owing
to multiplicity of organizations with overlapping mandates. Often
the decision-making is not evidence-based and there is no mechanism
of bridging the gap between evidence and policy. Elsewhere,
HTA is a frequently used tool in informing policy decisions in both
resource-rich and resource-poor countries. Despite national
organizations producing large volumes of research and clinical
guidelines, India has not yet introduced a formal HTA programme.
The incremental growth in healthcare products, services,
innovation in affordable medical devices and a move towards
universal healthcare, needs to be underpinned with an evidencebase
which focuses on effectiveness, safety, affordability and
acceptability to maximize the benefits that can be gained with a
limited healthcare budget. Establishing HTA as a formal process
in India, independent of healthcare providers, funders and
technology producers, together with a framework for linking
HTA to policy-making, would help ensure that the population
gets better access to appropriate healthcare in the future.
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Citation
KUMAR MRITYUNJAI, TAYLOR FIONA C, CHOKSHI MAULIK, EBRAHIM SHAH, GABBAY JOHN. Health technology assessment in India: The potential for improved healthcare decision-making. National Medical Journal of India. 2014 May-Jun ; 27 (3): 159-163.