HTHTAABenefits and RisksBenefits and Risks

Dr Bernard Merkel Dr Bernard Merkel European CommissionEuropean Commission

CommonCommon ChallengesChallenges

Demographic trendsDemographic trends Ageing populations, changing family structuresAgeing populations, changing family structures

New health technologiesNew health technologies New products and techniquesNew products and techniques

Higher expectations from citizensHigher expectations from citizens Information explosionInformation explosion

Health systems under pressureHealth systems under pressure Financial sustainabilityFinancial sustainability

Quality assuranceQuality assurance Developing mechanisms and maintaining themDeveloping mechanisms and maintaining them

What EU can do to help to What EU can do to help to meet these challenges? meet these challenges?

Health systemsHealth systems in general in generalEU can provide help to ensure EU can provide help to ensure health systems work as well as health systems work as well as possiblepossible InformationInformationBenchmarkingBenchmarkingSharing best practicesSharing best practices InvestmentInvestment

What EU can do to help to What EU can do to help to meet these challengesmeet these challenges??

HTAHTA Tool to improve quality and Tool to improve quality and sustainabilitysustainability

of health systemsof health systems Assessing new and emerging Assessing new and emerging

technologies help in cost technologies help in cost containmentcontainment

Rational priority settingRational priority setting

HTA in the Member HTA in the Member StatesStates

National National HTA agencies in the EUHTA agencies in the EU Austria, Belgium, Denmark, Finland, Austria, Belgium, Denmark, Finland,

France, Germany, France, Germany, Hungary, LatviaHungary, Latvia, , Netherlands, Spain, Sweden, and the Netherlands, Spain, Sweden, and the United Kingdom.United Kingdom.

Slovenia planning to establish an Slovenia planning to establish an agency, action in other MS as wellagency, action in other MS as well

HTA agencies HTA agencies collect, evaluate and collect, evaluate and produceproduce information and provide it information and provide it thenthen for policy making for policy making

INAHTA, the international network of INAHTA, the international network of HTA agencies HTA agencies is an active networkis an active network

What are the possibilities at What are the possibilities at the EU level?the EU level?

EMEA good EMEA good example of how example of how EU EU level level assessments assessments can can be done. be done. Commission Commission funded various funded various projects to projects to develop develop

methodology and methodology and foster foster

networking networking of HTA of HTA bodies bodies

Sustainable Sustainable EU network EU network

on HTA?on HTA?

What are the benefits and What are the benefits and risks of HTA at the EU risks of HTA at the EU

level?level?BenefitsBenefits

Avoid duplicationAvoid duplication Joint assessmentsJoint assessments More financial More financial

resourcesresources Guidance for MS in Guidance for MS in

developing HTAsdeveloping HTAs Pooling of expertisePooling of expertise Cross border issues i.e Cross border issues i.e

qualityquality Link international Link international

researchers and policy researchers and policy makers- one contact makers- one contact pointpoint

RisksRisks Definition of HTA and Definition of HTA and

methodologies differentmethodologies different National settings National settings

different i. e social, different i. e social, ethical situationsethical situations

National priorities National priorities different i. e who chooses different i. e who chooses and on what groundsand on what grounds

Concerns on Concerns on reimbursement and reimbursement and pricing issues pricing issues

Issues of involving Issues of involving industryindustry

Keeping the balanceKeeping the balance

How to address the risks?How to address the risks? Common definition and framework Common definition and framework Tailor HTA to national settings Tailor HTA to national settings Link between HTA and policy making/guidelinesLink between HTA and policy making/guidelines Common methods for creating reports on HTA Common methods for creating reports on HTA Identify needs and prioritising topics for Identify needs and prioritising topics for

European HTAs or primary research European HTAs or primary research Define what is HTA and what is not? Define what is HTA and what is not?

Pharmaceuticals?Pharmaceuticals? Transparency and quality assurance Transparency and quality assurance

What has been done on What has been done on HTA HTA

at the EU level?at the EU level? Several projects since 1994Several projects since 1994 Communication 2000Communication 2000 The Decision adopting the public The Decision adopting the public

health programmehealth programme Work Programme 2003Work Programme 2003

To develop mechanisms for bringing together To develop mechanisms for bringing together competent authorities in the EU and applicant countriescompetent authorities in the EU and applicant countries

Work Programme 2004Work Programme 2004 Quality assurance in EuropeQuality assurance in Europe

Work Programme 2005Work Programme 2005 Quality assurance in EuropeQuality assurance in Europe

What is currently done on What is currently done on HTA HTA

at the EU level?at the EU level? Patient Mobility Process Patient Mobility Process

Brought together health ministers and Brought together health ministers and other stakeholdersother stakeholders

December 2003: Report and nineteen December 2003: Report and nineteen recommendations – including health recommendations – including health technology assessment as a key themetechnology assessment as a key theme

April 2004: Commission issued April 2004: Commission issued response and established High Level response and established High Level Group of Health Services and Medical Group of Health Services and Medical CareCare

HTA in the Patient Mobility HTA in the Patient Mobility ProcessProcess

Commission was invited to consider Commission was invited to consider how a sustainable network and co-how a sustainable network and co-ordination function for HTA could be ordination function for HTA could be organised and fundedorganised and funded

HTA Working GroupHTA Working Group The Group to draw conclusions for the The Group to draw conclusions for the

Health Council in DecemberHealth Council in December Practical work to be taken forward to Practical work to be taken forward to

establish a mechanism to link establish a mechanism to link different projects, organisations and different projects, organisations and agencies to pool resultsagencies to pool results

EU Mechanism on Health EU Mechanism on Health Technology AssessmentTechnology Assessment

The mechanism could have the following The mechanism could have the following functions:functions:

Information Information Collaboration Collaboration Knowledge and skills Knowledge and skills Best practices in assessment Best practices in assessment EU level joint assessmentsEU level joint assessments Disseminating results of HTA Disseminating results of HTA HTA as part of evidence based decision-HTA as part of evidence based decision-

makingmaking Assessment of health interventions on Assessment of health interventions on

health promotion and disease preventionhealth promotion and disease prevention

ConclusionsConclusions Member States are facing common challenges Member States are facing common challenges

to their health systems; HTA is one tool to help to their health systems; HTA is one tool to help them.them.

Benefits from greater cooperation whilst Benefits from greater cooperation whilst respecting national responsibility for health respecting national responsibility for health systemssystems

A closer and more task-oriented collaboration A closer and more task-oriented collaboration and systematic exchange of information on HTA and systematic exchange of information on HTA to provide reliable, transparent and timely to provide reliable, transparent and timely information for policy decisions in the Member information for policy decisions in the Member States States

Further information onFurther information on

Public Health Policy atPublic Health Policy at

http://www.europa.eu.int/comm/health/index_en.htmhttp://www.europa.eu.int/comm/health/index_en.htm