Criteria for assessment of new technologies at the hospital level (mini-HTA) and the national level (HTA)

HTAi 2012Bilbao, June 25th 2012

Helene Arentz-Hansen, Senior researcher PhD, Norwegian Knowledge Centre for the Health Services

Population: 5 millions

4 Regional Health Authorities (RHA)

27 Local Health Authorities

Northern Norway RHA

Central Norway RHA

Western Norway RHA

South-Eastern Norway RHA

The Norwegian health system

National system for evaluation of new technologies in the specialist health services

Reasons: Unequal practices for decision-making processes around

introduction of new technologies into the health care system

Ensure equal access to established treatment

Ensure reasonable use of health resources A need for evidence-based, systematic introduction of new

technologies

HTA and mini-HTA

10. april 2023

HTA supports decision-making processes at the national

level when introducing new technologies

Policy

National guidelines

Clinical practice

EthicsLegal aspectsPatient perspectiveetc.

HTA-report

Impact assessment

Clinical effectivenessSafetyCost-effectiveness

Assessing the literature

Clinical research

10. april 2023

Mini-HTA will support decision-making processes when

introducing new health technologies at the hospital level

Mini-HTA is performed locally and take a few days (~ 5 days)

Policy

Clinical practice

OrganisationEthicsCosts

Mini-HTA

Impact assessment

Clinical effectivenessSafety

Assessing the literature

Clinical research

National guidelines

The Norwegian mini-HTA-form

The form is divided into 3 parts:

Part 1: Completed by the proposer physician, nurse, head of department etc.

Part 2: Completed by a peer reviewer An ”unbiased” person, for instance from another hospital Is the evaluation in part one performed satisfactorily?

Part 3: Recommendation for decision-maker Head of the department, managing director etc. Should the new technology be introduced into the health service?

Mini-HTA-form

Content:

1. About the new technology

2. The evidence (effectiveness, safety)

3. Ethics

4. Organisation

5. Costs

6. Summary and conclusions

Part 1: Completed by the proposer

1. When should mini-HTA be used?

2. When should mini-HTA not be used?

Criteria for using mini-HTA prior to introduction of new technologies in hospitals

Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued)

1. When should mini-HTA be used?

Uncertainty or disagreement regarding effectiveness or safety

Ethical issues

2. When should mini-HTA not be used?

A) The effectiveness and safety are known. No ethical issues.

B) It is obvious that the evidence concerning effectiveness and safety is limited

C) Type of technologies that should be evaluated at the national level

Screening Highly specialised health care Drugs Health economic evaluations

Criteria for using mini-HTA prior to introduction of new technologies in hospitals (continued)

How the results of the mini-HTA will be used as a basis for further decisions

If the effectiveness, safety and costs of the new technology are acceptable

The hospital can decide to introduce the new technology

Uncertainty remains concerning effectiveness and safety Exceeding of financial or organisational limits Ethical considerations of general interest May lead to differences in services between hospitals Need for assessment of cost-effectiveness

The decision concerning introduction of the new technology should be

lifted to a regional or national level

How the results of the mini-HTA will be used as a basis for further decisions

The national mini-HTA-database

Summary

A new system for evaluation of new technologies in the Norwegian health service will be introduced in 2012

This system is based on Health Technology Assessment as basis for decisions

Mini-HTA at the local level

HTA at the national level