Read the summary and the most important questions on Health Technology Assessment

• Introduction to HTA

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• Health Technology Assessment

  HTA is the systematic evaluation of properties, effects and/ or impacts of health technologies and interventions. It covers both direct, intended, consequences of technologies and interventions and their indirect, unintended consequences.

• What are the 6 steps of economic evaluation in health care?

  • study design
    
  • costs
  • benefits
  • discounting
  • sensitivity analysis
  • policy making

• 1) Study design: Who is paying? Which two perspectives are most dominant?

  • The health care payer perspective (Costs and effects falling on health care budget)
    
  • The societal perspective (All relevant costs and effects)

  
  
  But other perspectives such as patient or health insurance perspective play a role as well.

• Why is the choice of comparator important in economic evaluation?

  The economic evaluation is based on the comparison between the standard and alternative treatment. The choice of comparator determines the outcome as well.
  
  E.g. Do you compare an iphone with an old nokia or a samsung smartphone?

• 1) Study design: What are different types of analysis?

  • CMA: costs minimization analysis, focusses only on costs, effects are equal.
  • CBA: cost benefit analysis, focusses on cost and effects in monetary terms.
  • CEA: cost effectiveness analysis, costs in monetary terms, effects in natural units.
  • CUA: cost-utility analysis, costs in monetary terms, effects in QALYs.
  • BIA: budget impact analysis, costs on health care budget.

• 2) Costs: what should be considered in this step?

  • Identify all relevant costs
    
  • Measure resource use
  • Value resource use

• 3) Benefits: What should we consider in this step?

  • Identify effects
    
  • Measure effects
  • Value effects

• Medical costs

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• Name three types of expenses that can be considered in the identifying step.

  • Health sector expenses
    
  • Out of pocket expenses (travel to the hospital)
  • Productivity costs (due to illness not able to work)

• Health sector resources:

  Organizing and operating the programme including dealing with the adverse events caused by the programme.
  
  Identification: (often) listing the ingredients of te programme - both variable costs (time of health professionals or supplies) and fixed or overhead costs (e.g. light, heat, rent, or capital costs)

• In identifying the costs it is important to make a distiction between health care costs and societal costs. What is the difference?

  Health care costs include all costs that are related directly to health care, such as medication, staff, room, food.
  
  Societal costs include all costs that are related directly and indirectly to health care. In addition to the health care costs, it also includes travel costs, informal care costs and productivity losses.