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!