gms | German Medical Science

HTA has not reached its due position in Poland yet. Some politicians are "reluctant" to use evidence at all. Regulating health care is necessary as it is not a free market - the main difference is due to lack of information on the product purchased by the consumer (patient and provider). Reimbursement of certain technologies is actually giving a privileged market position.

Examples of HTA use in decision-making, in negotiations with payers and in respect to health programs selection as well as current changes in reimbursement policy in Poland and some other CEECs will be presented.

HTA contributes to discussions on the importance of comparison of optional technologies. Sometimes for political reasons even if costly but the only one efficacious method cannot be refused reimbursement. Not only ICER is important but also information on total investment on the procedure. Therefore cost-effectiveness coefficients ratio (CECR) and/or budget impact analyses are required.

Resources should be spent to provide affordable access for the community to necessary and cost-effective technologies. Polish HTA Agency was established by the Minister in September 2005. HTA Agencies focused on "production" of HTA reports, spend large public resources and employ many researchers - heavy model. But an HTA Agency may mostly assure quality of analyses directed to decision-makers. Light model HTA Agencies check validity and outcomes of analyses developed by the applying for reimbursement; consuming little public resources and employing relatively fewer experts.

Some existing educational programmes in Health Technology Assessment, Evidence Based Medicine, Pharmacoeconomics and Quality Assurance running in Poland will be mentioned. That refers to organizational content and achievements of specific postgraduate and university on-site educational programmes and courses as well as structured in-house training organized by universities, societies, government and other institutions.

Policy makers often receive economic evaluations on the same topic but with contradictory results so they do not know what to trust. Possibly HTA and pharmacoeconomic studies used in reimbursement should be transparent and made publicly available. Maybe HTA Agencies in CEECs should focus on quality assurance of the analyses submitted to authorities. The agencies could play the role of regulators of rapidly growing HTA national markets. Possibly the international quality assurance system in economic studies could also be introduced.

The complete lecture can be found on the website of DIMDI: http://www.dimdi.de/static/de/hta/symposien/2005/index.htm