How do I apply the principles to institutionalize HBP design based on best practices? |
Introduction
After the understanding the basic principles and familiarizing oneself with the relevant frameworks, it is necessary to consult guidance on best practices and to review information about the current situation in a country. Both types of resources are described in this section. Guidance on best practices are provided through a how-to guide for institutionalization as well through two other resources.
Key WHO resources and/or selected non-WHO resources for Putting the Principles into Practice
Guidance on Best Practices |
| Resource | Description | Reference |
1. What’s in, What’s out: designing benefits for universal health coverage. | This is a book developed by the Center for Global Development and partners for a global health audience. It presents a framework for HBP development, processes, and critical factors to consider. Invited commentary of the issues is also presented from policymakers. | Glassman, A., Giedion, U. and Smith, P.C. eds., 2017. What's in, what's out: designing benefits for universal health coverage. Brookings Institution Press. https://www.cgdev.org/publication/whats-in-whats-out-designing-benefits-universal-health-coverage |
| 2. A Roadmap for Systematic Priority Setting and Health Technology Assessment (HTA) | This report was developed by a group of HTA experts with the objective of advocating for the use of HTA in LMICs and to provide detailed information about institutionalization of HTA and the various processes. The report is structured according to an adapted stages model of policy processes. The authors conducted a systematic review of HTA in LMICs and conducted various expert feedback and workshops to develop the work. | Castro HE, Kumar R, Suharlim C, et al. 2020. A Roadmap for Systematic Priority Setting and Health Technology Assessment (HTA). Arlington, VA: USAID/MSH, 2020 |
3. Evidence-informed deliberative processes: A practical guide for HTA bodies for legitimate benefit package design, version 2.0 | This report was developed by researchers at Radboud University Medical Center as a guide for country HTA bodies, or those considering to develop one. The report provides practical guidance for how to conduct the various steps of the evidence-informed deliberative processes (EDP). Version 2.0 of this report includes more country specific experiences and learnings. | Oortwijn W, Jansen M, Baltussen R. Evidence-informed deliberative processes. A practical guide for HTA bodies for legitimate benefit package design. Version 2.0. Radboud university medical center, Nijmegen, 2021 |
4. Making explicit choices on the path to UHC: The JLN health benefits package revision guide | This guide was developed by the Joint Learning Network for Universal Health Coverage to provide practical guidance to LMICs on the process of continuously revising health benefits packages. |
Baltussen, R., L. Bijlmakers, S. Ghosh, J. Janssen, P. Baker, J. Guzman, Y L. Chi. (editors) (2022). “Making explicit choices on the path to UHC: The JLN health benefits package revision guide.” Joint Learning Network for Universal Health Coverage, International Decision Support Initiative (iDSI), The World Bank Group. https://www.jointlearningnetwork.org/resources/guide-for-health-benefits-package-revision/ |
| 5. NIPH Technical Guidance for Health Technology Assessment in Low- and Middle-Income Countries | This guide developed by the Norwegian Institute of Public Health (NIPH), outlines the technical approach to HTA development as well as the NIPH approach to support. There are 4 steps listed in more detail: topic identification, analysis, appraisal and decision-making, and policy implementation. A final section also lists available resources and tools that can be accessed for each of these steps. | Peacocke EF, Frønsdal KB, Heupink LF, Chola L, Lauvrak V, Bidonde J, of the NIPH Global Health Cluster. Technical guidance for Health Technology Assessment in Low-and middle-income countries. Oslo: Norwegian Institute of Public Health, March 2023. |
Situational Assessment |
| Resource | Description | Reference |
6. Country and regional surveys | There are several existing surveys on the status of HTA bodies in countries. These typically focus on a specific region of the world. Here we list several recent reports and peer-reviewed publications that describe these surveys and their results. (We have limited this review to studies conducted post 2015 and those looking across several countries, There are numerous previous studies and those looking at single countries.) | a. Asia: Teerawattananon, Y., Rattanavipapong, W., Lin, L., Dabak, S., Gibbons, B., Isaranuwatchai, W., . . . Babidge, W. (2019). Landscape analysis of health technology assessment (HTA): Systems and practices in Asia. International Journal of Technology Assessment in Health Care, 35(6), 416-421. doi:10.1017/S0266462319000667 b. Sub-Saharan Africa: Hollingworth, S., Fenny, A.P., Yu, SY. et al. Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. Cost Eff Resour Alloc 19, 39 (2021). https://doi.org/10.1186/s12962-021-00293-5 c. European Union and Norway: European Commission, Directorate-General for Health and Food Safety, Chamova, J., Mapping of HTA national organisations, programmes and processes in EU and Norway, Publications Office, 2018, https://data.europa.eu/doi/10.2875/5065 d. Central, Eastern and Southern Europe: García-Mochón L, Espín Balbino J, Olry de Labry Lima A, Caro Martinez A, Martin Ruiz E, Pérez Velasco R. HTA and decision-making processes in Central, Eastern and South Eastern Europe: Results from a survey. Health Policy. 2019 Feb;123(2):182-190. doi: 10.1016/j.healthpol.2017.03.010. Epub 2017 Mar 31. PMID: 28420539. https://www.sciencedirect.com/science/article/pii/S0168851017300854 e. Various LMIC: Joseph B Babigumira, Alisa M Jenny, Rebecca Bartlein, Andy Stergachis, Louis P Garrison, Health technology assessment in low- and middle-income countries: a landscape assessment, Journal of Pharmaceutical Health Services Research, Volume 7, Issue 1, March 2016, Pages 37–42, https://doi.org/10.1111/jphs.12120 f. 27 INAHTA member agencies: Oortwijn W, Jansen M, Baltussen R. Use of Evidence-Informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe. Int J Health Policy Manag. 2020 Jan 1;9(1):27-33. doi: 10.15171/ijhpm.2019.72. PMID: 31902192; PMCID: PMC6943303. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943303/ g. 32 LMICs: Oortwijn, W., Van Oosterhout, S., & Kapiriri, L. (2020). Application of evidence-informed deliberative processes in health technology assessment in low- and middle-income countries. International Journal of Technology Assessment in Health Care, 36(4), 440-444. doi:10.1017/S0266462320000549 https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/application-of-evidenceinformed-deliberative-processes-in-health-technology-assessment-in-low-and-middleincome-countries/5BC992EE7E45E861B0FFC479EA2B8259 |
| 7. HTA Implementation Scorecard | To be able to support HTA implementation plans, a group of HTA researchers have developed an HTA Implementation Scorecard and applied it in a range of countries in several regional settings. The 8 sections of the scorecard include: capacity building, funding, legislation, scope of implementation, decision criteria, quality and transparency of implementation, use of local data, and international collaboration. | a. Central and Eastern Europe: Kaló, Z., Gheorghe, A., Huic, M., Csanádi, M. and Kristensen, F.B., 2016. HTA implementation roadmap in Central and Eastern European countries. Health economics, 25, pp.179-192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066682/ b. Middle East and North Africa: Fasseeh A, Karam R, Jameleddine M, George M, Kristensen FB, Al-Rabayah AA, Alsaggabi AH, El Rabbat M, Alowayesh MS, Chamova J, Ismail A, Abaza S, Kaló Z. Implementation of Health Technology Assessment in the Middle East and North Africa: Comparison Between the Current and Preferred Status. Front Pharmacol. 2020 Feb 21;11:15. doi: 10.3389/fphar.2020.00015. PMID: 32153393; PMCID: PMC7046555. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046555/ c. Latin American Countries: Rosselli D, Quirland-Lazo C, Csanádi M, Ruiz de Castilla EM, González NC, Valdés J, Abicalaffe C, Garzón W, Leon G, Kaló Z. HTA Implementation in Latin American Countries: Comparison of Current and Preferred Status. Value Health Reg Issues. 2017 Dec;14:20-27. doi: 10.1016/j.vhri.2017.02.004. Epub 2017 May 15. PMID: 29254537. https://www.sciencedirect.com/science/article/pii/S2212109917300171 |
8. WHO Guide for Evidence-Informed Decision-Making | The WHO Guide for Evidence-Informed Decision-Making and its associated tool repository provide methods and tools to better leverage diverse forms of evidence for more effective policy and practice in the clinical, public health and health system fields. | WHO Evidence Informed Decision-Making Guide - 9789240039872-eng |
9. Surveys from Essential Medicines List (EML) and Essential Devices List (EDL) | The Essential Medicines List (EML) and Essential Devices List (EDL) are tools that are used in countries to prioritize those specific interventions. The WHO Global Atlas of Medical Devices provides information about health technology policies, regulatory bodies, HTA bodies (linking with the Global HTA and HBP survey), national lists of priority medical devices and more. |
|
10. iDSI iProse | The iDSI Progression Scale for institutionalising evidence-informed priority-setting in healthcare (iProSE) is a tool that can be used to assess the institutionalization of evidence-informed priority-setting in health. Countries and partners that are assisting them can use the scale to identify priority areas and tailor support. | iProSE — a scale for assessing progress on institutional use of evidence to inform priority-setting in health. “How-to” guide for applying iProSE in a country context. Center for Global Development, 2022. https://www.cgdev.org/publication/iprose-scale-assessing-progress-institutional-use-evidence-inform-priority-setting |
11. MSH Balanced Scorecard | The Balanced Scorecard (BSC) has been used to assess progress against 18 HTA institutionalization milestones in nine Asian countries. It allows comparison across countries and enables countries to identify areas that require further development. | Kumar, R., Suharlim, C., Amaris Caruso, A., Gilmartin, C., Mehra, M., & Castro, H. (2022). Assessing progression of health technology assessment implementation in Asia: A balanced scorecard for cross comparison of selected countries in Asia. International Journal of Technology Assessment in Health Care, 38(1), E60. doi:10.1017/S0266462322000423 |