Health technology assessment to change the face of medical policymaking

12/10/2018 03:08 PM


The Ministry of Health organised a workshop on October 4 on health technology assessment (HTA) and initial application outcomes in domestic medical policymaking. Deputy Health Minister Pham Le Tuan and Deputy Director of the Vietnam Social Security (VSS) Pham Luong Son attended the event.

The workshop also saw the participation of experts from Thailand’s Health Intervention and Technology Assessment Programme (HITAP); the VSS; the Health Strategy and Policy Institute; the Department of Social Insurance under the Ministry of Labour, Invalids, and Social Affairs; and the health ministry’s Department of Medical Examination and Treatment.

In his opening remarks, Deputy Minister Tuan said that like many other countries, Vietnam is making all-out efforts to pursue the target of health care for all. The intensified medical system will help control the rise of costs and widen the health network, which requires more resources amidst increased costs and limited medical funding. The HTA has been seen as an effective tool to improve the efficiency and effectiveness of the medical system, aiming to assist policymakers on decisions and policies on the basis of specific evidence.

Reality in many countries show that the HTA can significantly and practically contribute to developing medical policies relating to a number of priority spheres, such as basic health care package, medicine, and health services covered by health insurance; effective treatment methods; and treatment guidelines, drug price negociation.

Aware of the significance of the HTA in evidence-based policymaking, health leaders have paid due attention to intensifying HTA research and application. The health ministry has coordinated with domestic and foreign units and organisations in carrying out HTA activities in tandem with medical policy-building. Over the past time, the HTA has initially contributed to developing some important medical policies covering the types, conditions, and payment rates of several technological services and medicines covered by health insurance; as well as to building quality criteria in settling stroke and medicine price negotiation strategy.

Deputy Minister Tuan stressed that the workshop aims to assess HTA activities and its application in policymaking in Vietnam over the past time, in order to roll out an action plan in the time to come. He said the HTA is a new sector that requires the great joint efforts of all relevant sides to develop with strength, contributing to promptly providing evidence useful for medical policy-building.

At the workshop, experts highlighted the role of the HTA in building medical policies, putting together a list of medicines covered by health insurance, and building quality criteria in stroke settlement piloted in Vietnamese hospitals, as well as its application of medicine price negotiations in Vietnam.

 

Dr. Nguyen Khuong Anh, Deputy Director of the Health Strategy and Policy Institute, said that Vietnam has committed to fulfilling its target of full population coverage for health care based on health insurance. Meanwhile, the demand for health care has increased due to the expansion of disease pattern, the aging population, and the development of science-technology and information. However, the lack of resources and knowledge on how to use resources effectively has burdened the operation of the health care system. Given this, the HTA has been seen as a useful tool to help policymakers make decisions on identifying priorities, as well as selecting, using, allocating, and managing interventions in order to improve health; prevent, diagnose, and cure diseases; and rehabilitate in the context of limited resources.

Since 2014 – aware of the significance and role of HTA application in identifying priorities, effectively selecting and using medicines and technological services in health care – the Health Strategy and Policy Institute has proposed that health leaders put forth an HTA implementation plan, connect and set up relations with health organisations in training, and provide technical support for HTA activities.

After five years of implementation of HTA activities in Vietnam (2014-2018), public awareness of the role of the HTA has been improved. Furthermore, Vietnam has developed an HTA development plan with identified responsibilities and a set of criteria for HTA selection; established and consolidated an HTA network and staff to implement the network; set forth guidelines of HTA implementation; and conducted research studies on the HTA at different levels for 21 medicines and services. The HTA has received due attention and initially been put into service. Moreover, key policies have also been adjusted as part of the effort.

Sharing Thailand’s experience in using the HTA, a HITAP representative said the creation of healthcare evidence to apply in medical policy building focuses on medicine use, quality criteria, medical package adjustment, transformation of benefit packages, and community-based health programmes, contributing to improving health quality in the future.

Speaking of the initial outcomes of HTA application in building a list of medicine covered by health insurance in Vietnam, Dr. Ha Van Thuy, deputy head of the health ministry’s social insurance department, said that medical costs are increasing globally and that many countries have made efforts to control the incline. New medicines and cutting-edge technologies have fueled the hike in medical costs and health insurance alike.

Statistics show that medicine costs a large proportion of the total health insurance payment. In 2010, as much as 11.5 trillion VND out of the 18.6 trillion VND worth of health insurance payment was spent on medicines, or 61.6 percent. In 2016, health insurance payments totalled 97.1 trillion VND, with 31.3 trillion VND (41 percent) spent on medicines. Last year, health insurance payments stood at 97.1 trillion VND, with 34.9 trillion VND (34 percent) for medicines.

Therefore, the list of medicine covered by health insurance is one of the most important tools that can help effectively operate the health insurance system. No health insurance system in the world is able to pay for all the medicine on the market. In many countries, about 600 (API: active pharmaceutical ingredients) out of tens of thousands of medicines in the market were covered by health insurance. The HTA is the tool that decides the building of the list of medicines, as well as the methods and payment rate. Thuy said many Asian nations such as Malaysia, Singapore, China, the Philippines, the Republic of Korea, Thailand, Taiwan, and Iran have applied the HTA. Meanwhile, the HTA has yet to be officially applied in many countries including Viet Nam.

Vietnam Social Security