HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN KAZAKHSTAN: 4 YEARS’ EXPERIENCE OF ONE UNIT
Introduction. Over the past two decades, the implementation and using of the Hospital-based Health Technology Assessment (HTA) system in the practice of healthcare organizations has become widespread in the world, especially in Europe and the United States, being an effective tool for hospital management in managerial decision-making. Despite the fact that the implementation of the Health Technology Assessment system in the Republic of Kazakhstan began in 2009, the Hospital-based HTA is currently at an early stage of development, where the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan is one of the first examples of the implementation and using of this system by including in its structure the Hospital-based HTA Unit in 2015.
Aim of this study was to provide the main stages of the Unit’s development and the analysis of the effectiveness of using the results of HB-HTA reports in promoting informed managerial decisions on the viability of implementing and using new health technologies (innovations) in the Hospital’s practice.
Materials and methods. Information about the activities and stages of development of the Unit was obtained from the internal documentation of the Hospital. The data provided by the HB-HTA Unit and Hospital Administration were analyzed to confirm the comparability of the managerial decisions made on the implementation of new health technologies in the Hospital’s practice and recommendations of the conducted HTA.
The data necessary for estimating cost savings due to the refusal to implement ineffective health technologies were obtained from the Hospital Information System, and data provided by manufacturers and distributors of medical equipment in Kazakhstan.
Results. For the 4-year period from 2015 to 2018, the Unit prepared 55 mini-reports on Hospital-based HTA. Seventeen health technologies (31%) were not recommended for implementation in the Hospital’s practice. Refusal to implement sixteen of these technologies saved approximately 287,290,000 KZT.
Of the 38 recommended health technologies, 29 technologies (76%) were implemented into the Hospital’s practice to treat or diagnose 2,119 patients. Seven technologies were included in the Plan for the implementation of new technologies for 2019-2020. Twelve of the 29 implemented health technologies did not require additional investments. The payback period of investments for the other 17 implemented technologies is not more than 3 years for eight, less than 5 years for seven, and more than 10 years for two technologies.
Conclusions. Establishment of the Hospital-based HTA Unit at the Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan created the basis for making informed managerial decisions about the viability of the implementation and using in practice various health technologies; identifying key directions for strategic and innovative development; and improving hospital management.
Andrey V. Avdeyev *1,2, https://orcid.org/0000-0001-8509-6053
Adlet B. Tabarov 3, Valeriy V. Benberin 1, Nasrulla A. Shanazarov 1,
Aygul K. Kaptagayeva 4, Lyazzat Zh. Zhanabekova 1, Aliya M. Gizatullina 1,
Yenlik Ye. Zhumagali 1, Larissa G. Makalkina 2, Nazar K. Seidalin1
1 Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Nur-Sultan, The Republic of Kazakhstan;
2 Astana Medical University, Nur-Sultan, The Republic of Kazakhstan;
3 Republican Center for Health Development, Nur-Sultan, The Republic of Kazakhstan;
4 Mediker group of companies, Nur-Sultan, The Republic of Kazakhstan.
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29. Sampietro-Colom L., Morilla-Bachs I., Gutierrez-Moreno S., Gallo P. Development and test of a decision support tool for hospital health technology assessment // Int J Technol Assess Health Care. 2012 Oct;28(4):460-5. Doi: 10.1017/S0266462312000487.
30. Sharip B., Tabarov A., Avdeyev A., Kaptagayeva A., Zhanabekova L., Gizatullina A. Implementation of Hospital-based Health Technology Assessment in the Republic of Kazakhstan (2 years’ experience) // ISPOR 22nd Annual International Meeting Research Abstracts. Value in Health, Volume 20 Issue 5 May 2017, A24-A25.
31. Sussex J., Rollet P., Garau M., Schmitt C., Kent A., Hutchings A. A pilot study of multicriteria decision analysis for valuing orphan medicines // Value Health. 2013 Dec; 16(8): 1163–9.
32. Tabarov A.B., Altynova S.K., Hailey D. The efficacy and safety of early initiation of dialysis versus late-onset patients with end-stage renal failure // Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 34.
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34. Thokala P., Duenas A. Multiple criteria decision analysis for health technology assessment // Value Health 15 (8) (2012 Dec) 1172–1181.
References:
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4. Almadiyeva A., Tabarov A., Kostyuk A. Clinical effectiveness and cost-effectiveness of combination therapy with interferon (pegylated or nonpegylated) and ribavirin compared with interferon monotherapy (pegylated or nonpegylated) for the treatment of chronic hepatitis C in adult patients. Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 72.
5. Cicchetti A., Marchetti M., Dibidino R., Corio M., on behalf of HTAi’s Hospital Based Sub Interest Group: Hospital based HTA. Hospital based health technology assessment. World-wide survey. URL: https://htai.org/wp-content/uploads/2018/02/HospitalBasedHTAISGSurveyReport.pdf (дата обращения 24.03.2019 г)
6. Bodeau-Livinec F., Simon .E, Montagnier-Petrissans C., Joel M.E., Fery Lemonnier E. Impact of CEDIT recommendations: an example of health technology assessment in a hospital network. Int J Technol Assess Health Care. 2006, 22:161–168.
7. Demerdjian G. A 10-year hospital-based health technology assessment program in a public hospital in Argentina. Int J Technol Assess Health Care. 2015; 31:103-110.
8. Diaby V., Goeree R. How to use multi-criteria decision analysis methods for reimbursement decision-making in healthcare: a step-by-step guide. Exp. Rev. Pharmacoeconom. Outcomes Res. 14 (1) (2014) 81–99.
9. Gagnon M.P., Abdeljelil A.B., Desmartis M., Légaré F., Ouimet M., Gagnon J., St-Pierre M., Rhainds M., Coulombe M. Opportunities to Promote Efficiency in Hospital Decision-Making Through the Use of Health Technology Assessment. Canadian Health Services Research Foundation: Ottawa; 2011, 28 p. URL: https://www.cfhi-fcass.ca/sf-docs/default-source/commissioned-research-reports/Gagnon-Dec2011-EN.pdf?sfvrsn=0 (дата обращения 24.03.2019 г.).
10. Gizatullina A., Muhametkaliev S. Coronary stents (bare metal versus drug eluting) in patients with STEMI: review of clinical and economic effectiveness. Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 44.
11. Gurtner S. Making the right decisions about new technologies: a perspective on criteria and preferences in hospitals. Health Care Manage. Rev. 2014. 39(3). 245–254.
12. Hailey D, Tabarov A. FISH and other cytogenetic methods in early prenatal diagnosis. Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 32.
13. Health technology assessment. Int J Technol Assess Health Care, 2009, 25 Suppl 1, p.10.
14. International HTA Glossary definition, Health Technology Assessment international. URL: http://htaglossary.net/health+technology+assessment+%28HTA%29 (accessed: 24.03.2019 г.).
15. Ivlev I., Kneppo P., Bartak M. Multicriteria decision analysis: a multifaceted approach to medical equipment management. Technol. Econ. Develop. Econ. 20 (3) (2014) 576–589
16. Ju H., Hewson K. Health technology assessment and evidence-based policy making: Queensland Department of Health experience. Int J Technol Assess Health Care. 2014; 30:595-600.
17. Kidholm K., Ehlers L., Korsbek L., Kjaerby R., Beck M. Assessment of the quality of mini-HTA. Int J Technol Assess Health Care. 2009 Jan;25 (1):42-8. Doi: 10.1017/S0266462309090060.
18. Kosherbayeva L., Hailey D. Bilateral and unilateral cochlear implantation in children. Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 47.
19. Kosherbayeva L., Hailey D., Kurakbaev K., Tsoy A., Zhuzzhanov O., Donbay A., Kumar A., Nadyrov K. Implementation of health technology assessment work in a hospital in Kazakhstan. Int J Technol Assess Health Care. 2016; 32 (1-2): 78-80. Doi: 10.1017/S0266462316000076.
20. Marsh K., IJzerman M., Thokala P., Baltussen R., Boysen M., Kaló Z., Lönngren T., Mussen F., Peacock S., Watkins J., Devlin N. ISPOR Task Force. Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 2016 Mar-Apr;19(2):125-37. doi: 10.1016/j.jval.2015.12.016.
21. Martin J. Evidence in Context: Hospital-based HTA adds significantly to Arms-Length HTA in Canada. Panel Session - “Same, same but different: HTA in and for Hospital at Health Technology Assessment International”. HTAi 11th Annual Meeting Abstract Volume, Washington. 2014, 189:14.
22. McGregor M. The Impact of Reports of the Technology Assessment Unit of the McGill University Health Centre. Montreal (Canada): Technology Assessment Unit (TAU) of the McGill University Health Centre (MUHC); 2012 Sep 13. Report no. 65. 35 p.
23. Mitchell M.D., Williams K., Brennan P.J., Umscheid C.A. Integrating local data into hospital-based healthcare technology assessment: two case studies. Int J Technol Assess Health Care 2010, 26:294–300. Doi: 10.1017/ S0266462310000334.
24. Nielsen C.P., Funch T.M., Kristensen F.B. Health technology assessment: research trends and future priorities in Europe. J Health Serv Res Policy. 2011;16 Suppl 2:6-15.
25. P101928. Health Sector Technology Transfer and Institutional Reform. Ministry of Healthcare of the Republic of Kazakhstan, World Bank. Approval Date: January 15, 2008. Closing Date: June 30, 2017. URL: http://projects.worldbank.org/P101928/health-sector-technology-transfer-institutional-reform?lang=en&tab=overview (accessed:24.03.2019 г.).
26. Poulin P., Austen L., Kortbeek J.B., Lafreniere R. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department. Surg Innov. 2012, 19: 187–199. Doi: 10.1177/ 1553350611421916.
27. Sampietro-Colom L., Lach K., Cicchetti A., Kidholm K., Pasternack I., Fure B., Rosenmöller M., Wild C., Kahveci R., Wasserfallen J.B., Kiivet R.A., et al. The AdHopHTA handbook: a handbook of hospital based Health Technology Assessment (HB -HTA). Public deliverable; The AdHopHTA Project (FP7/2007 -13 grant agreement nr 305018); 2015. URL: http://www.adhophta.eu/handbook (accessed: 24.03.2019 г.).
28. Sampietro-Colom L., Lach K., Pasternack I., Wasserfallen J.B., Cicchetti A., Marchetti M., Kidholm K., Arentz-Hansen H., Rosenmöller M., Wild C., Kahveci R., Ulst M. Guiding principles for good practices in Hospital-based Health Technology Assessment units. Int J Technol Assess Health Care. 2015;31(6):457-65. Doi: 10.1017/ S0266462315000732.
29. Sampietro-Colom L., Morilla-Bachs I., Gutierrez-Moreno S., Gallo P. Development and test of a decision support tool for hospital health technology assessment. Int J Technol Assess Health Care. 2012 Oct;28(4):460-5. Doi: 10.1017/S0266462312000487.
30. Sharip B., Tabarov A., Avdeyev A., Kaptagayeva A., Zhanabekova L., Gizatullina A. Implementation of Hospital-based Health Technology Assessment in the Republic of Kazakhstan (2 years’ experience). ISPOR 22nd Annual International Meeting Research Abstracts. Value in Health, Volume 20 Issue 5 May 2017, A24-A25.
31. Sussex J., Rollet P., Garau M., Schmitt C., Kent A., Hutchings A. A pilot study of multicriteria decision analysis for valuing orphan medicines. Value Health. 2013 Dec; 16(8): 1163–9.
32. Tabarov A.B., Altynova S.K., Hailey D. The efficacy and safety of early initiation of dialysis versus late-onset patients with end-stage renal failure. Centre of standardization, Republican Centre for Health Development, Ministry of Healthcare of the Republic of Kazakhstan. Astana, March 2013, p. 34.
33. Thokala P., Devlin N., Marsh K., Baltussen R., Boysen M., Kalo Z., Longrenn T., Mussen F., Peacock S., Watkins J., Ijzerman M. Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 2016 Jan; 19(1): 1-13. doi: 10.1016/j.jval.2015.12.003.
34. Thokala P., Duenas A. Multiple criteria decision analysis for health technology assessment. Value Health. 15 (8) (2012 Dec) 1172–1181.
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Авдеев А.В., Табаров А.Б., Бенберин В.В., Шаназаров Н.А., Каптагаева А.К., Жанабекова Л.Ж., Гизатуллина А.М., Жумагали Е.Е., Макалкина Л.Г., Сейдалин Н.К. Госпитальная оценка медицинских технологий в Казахстане: 4-х летний опыт одной организации // Наука и Здравоохранение. 2019. 2 (Т.21).С. 98-107. Avdeyev A.V., Tabarov A.B., Benberin V.V., Shanazarov N.A., Kaptagayeva A.K., Zhanabekova L.Zh., Gizatullina A.M., Zhumagali Ye.Ye., Makalkina L.G., Seidalin N.K. Hospital-based health technology assessment in Kazakhstan: 4 years’ experience of one unit // Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 2, pp. 98-107. Авдеев А.В., Табаров А.Б., Бенберин В.В., Шаназаров Н.А., Каптагаева А.К., Жанабекова Л.Ж., Гизатуллина А.М., Жумагали Е.Е., Макалкина Л.Г., Сейдалин Н.К. Қазақстандағы медициналық технологияларды госпитальдық бағалау: бір ұйымның 4 жылдық тәжірибесі // Ғылым және Денсаулық сақтау. 2019. 2 (Т.21). Б. 98-107.Related publications:
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