HTA in Poland

Wojciech Matusewicz, Ph.D., M.D. – Director

Iga Lipska, M.D. – Head of HTA Department

Agency for Health Technology Assessment in Poland AHTAPol

1. Poland and Polish health care system

2. AHTAPol legal basis

3. AHTAPol tasks and activities

4. AHTAPol analytic team

5. Drug reimbursement / HTA

Poland

Polish health care system

• Centralised• Health insurance system - taxes• National Health Fund (NHF)• 16 regional branches • NHF concludes contracts with health service providers• NHF budget for 2009 is 56,8 billion PLN (14 billion EURO)• Drug reimbursement - 7,3 billion PLN (12,9%)• Therapeutic drug programs - 1,3 billion PLN (2%)• Total public spending about 4% GDP.

AHTAPol - Legal basis

• Created in 2005 (Ordinance by MoH Sept 2005)• The possible lowest legal act• So far updated every year:

June 2006 Sept 2007 Sept 2008

• Steps undertaken to prepare the Law on AHTAPol establishment

• The Bill prepared and submitted for Parliament work• Planned to come into force in 2009 (June?)

AHTAPol – tasks and activities

• Still a lot of discussions• Which activities should be performed by this institution• Which model of the Agency should be implemented

Light Heavy (limitations) Mixed

• International collaboration! EUnetHTA, INAHTA, HTAi, ISPOR, GIN

• Drug reimbursement list (Transparency Directive!)• Therapeutic programmes• Non – drug technologies

AHTAPol - tasks and activities

0 0 0

7

5

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40

23

3

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15

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2006 2007 2008

drugs-reimbursement list

drugs-therapeutic programs

non-drug technologies

• Horizon scanning/new and emerging technologies

Early warning/awarness system

• Stakeholders’ involvement• Screenning programmes• Education in HTA

Cascading/distance learning programmes

• Registries• Clinical Practise Guidelines• Eastern Dimension Capacity Building

AHTAPol – FUTURE tasks and activities

AHTAPol - Analytic team

• Build a strong team - one of the biggest tasks for a new institution

• Motivation system created to maintain people working in Agency Continuous trainings International collaboration Professional development

• Money, money, money…• Maybe not only : ))• Salaries - public administration v. private sector

AHTAPol - Analytic team POSSIBILITIES

• EU funded project 2 million EURO• Twinning project Poland - France (Oct 2006 - Apr 2008)• 2 Components: • Institutional - proposals of structural and procedural

improvements for AHTAPol and other institutions• Trainings in EBM and HTA

DOERS – about 30 people USERS – about 300 people Training for trainers – about 15 people trainned 7 internships 2 months long CORE of THE TEAM 1 internship 6 months long

AHTAPol - Analytic team

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9

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23

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5

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25

June 2006 Dec 2006 Dec 2007 Dec 2008

Analysts

Drug reimbursement / HTA

• Drug reimbursement list• Therapeutic programmes• Revision of applications

Submitted by the industry

• Assessment of analysis in terms of credibility and quality Clinical effectiveness Cost effectiveness

Budget impact analysis • Consultative Council (CC) – the role

CC recommendation types

• “Finance” • “Finance temporarily, provided that the data are

gathered to a final decision”• ”Finance provided that some precisely criteria are met

or in particular indications” • “Finance provided that a cost-effective way of financing

was assured” • “Not to finance” • “Increase financing” • “Decrease financing” • ”Not to change financing”

HTA in decision making process

• Assessment and Appraisal• Completely separated processes• Assessment/Revision of industry submission – by

Analytic Team• Appraisal – by Consultative Council • CC recommendation• Decision making – Ministry of Health

• Thank you for your attention

• Questions???