Financial Management HPI4007 – Case 3 Lecture +
Learning Goals
1.Why is the traditional HTA methodology difficult to apply in health care organizations?
HTA (European Commission): a multidisciplinary process that summarizes information about he
medical, social, economic and ethical issues related to the use of health technology in a systematic,
transparent, unbiased and robust manner
The goal of HTA is to:
To inform decision making
To improve the quality of care by promoting an appropriate and rational use of health
technologies
Why HTA:
Increasing healthcare costs
Budget constraints
Rapid development of (expensive) medical technological possibilities
Hospital managers have to efficiently allocate healthcare resources and therefore there
is an increasing use of HTA both in regulatory bodies (HTA) and organizations (e.g.
hospitals)
Typical structure of HTA REPORT:
1. Introduction (research question)
2. Disease
3. Technology
4. Clinical effectiveness
5. Economic review
6. Cost-effectiveness (decision-analytic model)
7. Ethical, legal and social implications
8. Discussion
9. Policy recommendations
This often takes a long time to conduct, therefore in hospitals managers often conduct a
mini-HTA.
Often cost-effectiveness and cost-
utility are used for economic
evaluations. However, in hospitals
this is not the case. There is an
increased use of economic data in
healthcare decision making and this
is formally used in drug
reimbursement decisions.
HTA in an healthcare organization:
-Increasing interest due to quality and efficiency of care in hospitals
-> Could facilitate decision-making regarding acquisition, implementation or discontinuation of
technologies or interventions within the hospital
1
, Important barriers in the use of traditional HTA in a healthcare organization:
1. HTA Methodology-related factors
Complexity of HTA studies (= no time or experience in HC)
Lots of assumptions in economic evaluations (=large model with a lot data)
Greater attention to national/regional level (=hospital is only interested in hospital
perspective)
Societal perspective vs hospital perspective
Cost-effectiveness neglects budget impact
Absence of hospital-HTA guidelines (=no guidelines exists for HTA in hospital)
2. Management-related factors
Budget: a lot of resources (money/time) is needed
Access and time constraints
Hospital managers report giving greater importance to effectiveness and budgetary
impact
Poor understanding of concepts, principles and methods
Lack of legal and regulatory factors (if you are not forced to use HTA, you will have
low motivation to use it)
2. What is hospital-based HTA and how does it differ from a traditional HTA study?
Hospital-based HTA (HB-HTA): performing HTA activities tailored to the hospital context to inform
managerial decisions on different types of health technologies. It includes processes and methods
used to produce HTA reports in and for hospitals
There are different reasons to adopt Hospital Based HTA (6):
1. It is a tool for prioritization
2. It provides hospital decision-makers (managers and clinicians) with science-based,
multifaceted information and the necessary arguments on which to base the decision on
whether or not to invest in a technology
3. Derived information is superior to that provided by national or regional HTA agencies
because it is a) rapid and timely, b) tailored to the hospital’s setting, and c) tailored to the
information requirements of hospital managers
4. It increases effectiveness of technologies used in the hospital
5. It improves efficiency in the hospital budget management
6. It may lead to improved patient safety
International collaborations in HB-HTA:
Health Technology Assessment international (HTAi): SIG
AdHopHTA: large project funded by European Commision
Gagnon (2014): established a framework of
hospital-based HTA models.
= It has two dimensions:
1. Organizational complexity
- Low
(individual –
person doing
the work)
- High (team-
group-unit)
2
Learning Goals
1.Why is the traditional HTA methodology difficult to apply in health care organizations?
HTA (European Commission): a multidisciplinary process that summarizes information about he
medical, social, economic and ethical issues related to the use of health technology in a systematic,
transparent, unbiased and robust manner
The goal of HTA is to:
To inform decision making
To improve the quality of care by promoting an appropriate and rational use of health
technologies
Why HTA:
Increasing healthcare costs
Budget constraints
Rapid development of (expensive) medical technological possibilities
Hospital managers have to efficiently allocate healthcare resources and therefore there
is an increasing use of HTA both in regulatory bodies (HTA) and organizations (e.g.
hospitals)
Typical structure of HTA REPORT:
1. Introduction (research question)
2. Disease
3. Technology
4. Clinical effectiveness
5. Economic review
6. Cost-effectiveness (decision-analytic model)
7. Ethical, legal and social implications
8. Discussion
9. Policy recommendations
This often takes a long time to conduct, therefore in hospitals managers often conduct a
mini-HTA.
Often cost-effectiveness and cost-
utility are used for economic
evaluations. However, in hospitals
this is not the case. There is an
increased use of economic data in
healthcare decision making and this
is formally used in drug
reimbursement decisions.
HTA in an healthcare organization:
-Increasing interest due to quality and efficiency of care in hospitals
-> Could facilitate decision-making regarding acquisition, implementation or discontinuation of
technologies or interventions within the hospital
1
, Important barriers in the use of traditional HTA in a healthcare organization:
1. HTA Methodology-related factors
Complexity of HTA studies (= no time or experience in HC)
Lots of assumptions in economic evaluations (=large model with a lot data)
Greater attention to national/regional level (=hospital is only interested in hospital
perspective)
Societal perspective vs hospital perspective
Cost-effectiveness neglects budget impact
Absence of hospital-HTA guidelines (=no guidelines exists for HTA in hospital)
2. Management-related factors
Budget: a lot of resources (money/time) is needed
Access and time constraints
Hospital managers report giving greater importance to effectiveness and budgetary
impact
Poor understanding of concepts, principles and methods
Lack of legal and regulatory factors (if you are not forced to use HTA, you will have
low motivation to use it)
2. What is hospital-based HTA and how does it differ from a traditional HTA study?
Hospital-based HTA (HB-HTA): performing HTA activities tailored to the hospital context to inform
managerial decisions on different types of health technologies. It includes processes and methods
used to produce HTA reports in and for hospitals
There are different reasons to adopt Hospital Based HTA (6):
1. It is a tool for prioritization
2. It provides hospital decision-makers (managers and clinicians) with science-based,
multifaceted information and the necessary arguments on which to base the decision on
whether or not to invest in a technology
3. Derived information is superior to that provided by national or regional HTA agencies
because it is a) rapid and timely, b) tailored to the hospital’s setting, and c) tailored to the
information requirements of hospital managers
4. It increases effectiveness of technologies used in the hospital
5. It improves efficiency in the hospital budget management
6. It may lead to improved patient safety
International collaborations in HB-HTA:
Health Technology Assessment international (HTAi): SIG
AdHopHTA: large project funded by European Commision
Gagnon (2014): established a framework of
hospital-based HTA models.
= It has two dimensions:
1. Organizational complexity
- Low
(individual –
person doing
the work)
- High (team-
group-unit)
2
