HTA Activities in Australia and New Zealand Catherine Voutier Centre for Clinical Effectiveness.
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Transcript of HTA Activities in Australia and New Zealand Catherine Voutier Centre for Clinical Effectiveness.
HTA Activities in Australia and New Zealand
Catherine VoutierCentre for Clinical Effectiveness
The overview
An overview of Health Technology Assessment (HTA) in Australia and New Zealand. In this presentation, the organisations currently involved in HTA activities will be described, including a brief history, along with the various projects they are involved in.
Why do clinical librarians need to know about HTA?
Many clinicians do not know the term or understand how it affects their decision-making
HTA also covers interventions where there may be a low level of evidence
HTA considers the context in which the intervention is to be utilised
Has a great impact in the development of other activities
What is Health Technology Assessment (HTA)?
Systematic evaluation by interdisciplinary groups Explicit analytical frameworks drawing from a variety
of methods Properties, effects, and/or impacts of health care
technology (drugs, surgical techniques, tools etc) Direct, intended consequences of technologies Indirect, unintended consequences Its main purpose is to inform technology-related
policymaking in health care. HTA 101 Glossary National Information Center on Health Services Research and Health Care
Technology (NICHSR), NLM. http://www.nlm.nih.gov/nichsr/hta101/ta101014.html Accessed 23.06.06
Evolution of HTA in Australasia
Pharmaceutical Benefits Advisory Committee (PBAC) – established 1954
National Health Technology Advisory Panel (NHTAP) – early 1980’s
Australian Health Technology Assessment Committee (AHTAC) – 1986
(Pharmaceutical Management Agency (PHARMAC) – 1993 (fully estab. 2000)
NZHTA established - 1997 Medical Services Advisory Committee (MSAC) - 1997/98 Other HTA groups begin forming
NZHTA – New Zealand Health Technology Assessment
Established in 1997 by the New Zealand Ministry of Health to assist NZ Health and Disability Services
Produces a range of assessments such as systematic reviews, technical briefs, and horizon scanning for HealthPACT. Conducts assessments for MSAC, the Accident Compensation Corporation, NZ Guidelines Group and others
Involved in regional activities: Clinical Decision Support Unit, Clinical Practice Committee
Employs a medical librarian
NZHTA Publications for MSAC
– Implantable cardioverter defibrillators for prevention of sudden cardiac death
– Cardiac resynchronisation therapy for severe heart failure
– The use of INR point-of-care testing in general practice
– CEA-Scan for imaging recurrence &/or metastases in patients with histologically demonstrated carcinoma of the colon or rectum
Other NZHTA Publications
Technical ReviewsThe effectiveness of interventions to promote fruit and vegetable intake in school-aged children - April 2006Effective models of mental health service provision and workforce configuration in the primary care setting - Feb 2006
Systematic ReviewsSystematic review of the health effects of modified smokeless tobacco products - Feb 2007
Screening strategies for antenatal Down Syndrome screening. A systematic review of the literature - Nov 2006
MSAC – Medical Services Advisory Committee
Established in 1997-98, the Committee advises the Minster of Health and Ageing of the cost-effectiveness, safety and effectiveness of new procedures and technologies presented for Medicare funding
Compliments the activities of:– Medicare Benefits Consultative Committee– Pathology Services Table Committee– Consultative Committee on Diagnostic Imaging
MSAC – Terms of Reference
Advises the Minister on– Strength of evidence of new and emerging
technologies/procedures and to what extent public funding should be supported
– What technologies/procedures should be given interim funding in order to collect enough evidence to determine effectiveness
– Report references of new and emerging technologies and procedures
Undertake HTAs referred by the Australian Health Ministers’ Advisory Council (AHMAC) and report to same
MSAC Review Cycle
Eligibility– The Department of Health and Ageing decides if
the application is eligible for assessment by MSAC
Assessment– MSAC contracts out the majority of HTAs. An
assessment protocol is developed and a specialist advisory panel is created to assist in the process
MSAC Review Cycle
Formulation of Advice to the Minister– MSAC presents the assessment, Department opinion and
MSAC recommendations to the Minister
Decision– The Minister, with the material presented, either rejects or
accepts the recommendations. To date, all recommendations have been endorsed
Implementation– The appropriate committee decides on funding levels
MSAC - Publications
Applications (under review)– Autologous cartilage implantation (ACI) – Hepatitis B DNA testing – Lumber non-fusion posterior stabilisation devices
Completed Assessments– Advanced breast biopsy instrumentation – Visual electrodiagnosis
HealthPACT – MSAC subcommittee
HealthPACT – Health Policy Advisory Committee on Technology
– Terms of reference: to assist the introduction of new and emerging medical technologies into the public sector, provide a forum for national and international discussion, inform AHMAC, and supported by the National Horizon Scanning Unit. Comprises members from MSAC, ASERNIP-S, DoHA and the New Zealand Ministry of Health
– Is a key operator of the Australia and New Zealand Horizon Scanning Network (ANZHSN), an initiative of MSAC, the Australian Government Department of Health and Ageing and all Australian Health Ministers' Advisory Council (AHMAC) jurisdictions.
PBAC- Pharmaceutical Benefits Advisory Committee
Established in 1954, PBAC advises the Minister of Health and Ageing on which pharmaceuticals and other products should attract pharmaceutical benefits
PBAC recommendations assess the effectiveness and cost of proposed benefits as well as possible restrictions and supply issues
PBAC recommendations (medicines only) are made available as Public Summary Documents (PSDs) on the Department of Health and Ageing website
IMS Pricing & Market Access (P&MA)
Established in 1995 and part of IMS Health from 2005, P&MA (formerly known as M-TAG) provides services to PBAC, MSAC and various other bodies both local and international.
– Staff serve on an evaluation panel similar to MSAC for the Commonwealth Government
Main role is to present reimbursement applications to PBAC and to date, has supplied over 200 applications.
Employs a medical librarian
HTAnalysts - Sydney
Similar services to IMS P&MA Public and private clients Specialises in
– PBAC reimbursement applications – MSAC applications for medical services, devices,
procedures and diagnostic tests Conducts clinical, basic and applied research http://www.htanalysts.com/index.htm
ASERNIP-S
Australian Safety and Efficacy of New Interventional Procedures – Surgical– Supported by Australasian College of Surgeons
Assesses new and emerging surgical technologies & techniques via– Horizon Scanning– Systematic Reviews of the literature– Clinical and research audits/trials– Clinical guidelines
ASERNIP-S Publications
Systematic reviews:– Surgical simulation: a systematic review (update),
August 2006 – Paravertebral blocks for anaesthesia and
analgesia: A Systematic Review, January 2006 NETS:
– Artificial cervical disc replacement(update)
– Injection snoreplasty
AHTA - Adelaide Health Technology Assessment
Established in 2001, AHTA provides evidence-based assessments on a variety of technologies, services and procedures
Specialised systematic literature reviews for PBAC, MSAC, NICS, NHMRC and others
Guideline development Horizon scanning Information needs supported by the University
Library
AHTA Publications
Systematic reviews– Vertebroplasty August 2005
Critical Appraisal– NHMRC review of “Clinical practice guidelines for stroke recovery
rehabilitation and recovery (National Stroke Foundation)”. June 2005.
– NHMRC GAR consultant review of “Management of diabetic retinopathy (Australian Diabetes Society)”. August 2003 – 2005
Horizon Scanning – Microvolt T-wave alternans for the determination of patients likely
to benefit from ICD therapy (Feb 2007)– Available from the Australian and New Zealand Horizon Scanning
Network, http://www.horizonscanning.gov.au/
CCE – Centre for Clinical Effectiveness
CCE and the Australasian Cochrane Centre underwent organisational restructuring in early 2005. This resulted in the CCE HTA team moving to Cochrane. CCE HTA reports can still be found on the MSAC Publications web page.
About me
Research Officer (Information) at CCE:– Searching/information retrieval – Assists staff in their research projects (this may include
appraising guidelines, copy editing, investigating copyright issues etc)
– Collaborates with other librarians on various projects
Questions? Please come to see me afterwards at break. I have a hearing impairment so I won’t be taking questions from the audience.
Thank you
AcknowledgementsPip Dival and Sarah Sutton for inviting me to join
you here today, Becky Skidmore, Susan Bidwell (HTA librarians) and Janet Hiller (AHTA) – for their advice and encouragement.
Websites
NZHTA– http://nzhta.chmeds.ac.nz/index.htm
MSAC– http://www.msac.gov.au
AHTA– http://www.health.adelaide.edu.au/publichealth/consult/
health_technol_assess.html ASERNIP-S
– http://www.surgeons.org/Content/NavigationMenu/Research/ASERNIPS/default.htm
INAHTA– http://www.inhata.org
IMS P&MA– http://www.m-tag.net