Transcript Tucsike elso oraja - European Health Forum Gastein | EHFG

National HTA strategies; the case of
Hungary
László Gulácsi PhD
Chair Professor
Corvinus University of Budapest
Unit of Health Economics and Health
Technology Assessment HunHTA
Presented at the 7th European Forum
Gastein, 7th October, 2004
The „New iron curtain”
(standardised death rate, both sexes, 1990)
HunHTA Unit of Health Economics and Health Technology Assessment
DEFICIT of the Hungarian National Health
Insurance Fund (cont.)
30%
% of EXPENDITURES
25%
23,2%
19,9%
20%
15%
10,1%
11,2%
8,5%
10%
6,8%
8,0%
7,8%
5,0% 5,0%
5%
3,3%
0%
1994. 1995. 1996. 1997. 1998. 1999. 2000. 2001. 2002. 2003. 2004.
HunHTA Unit of Health Economics and Health Technology Assessment
Issues of the ‘Fourth Hurdle’
The first three hurdles, which already exist in
most countries, require the demonstration of
efficacy, safety and quality of manufacturer.
Several countries have already introduced the
‘fourth hurdle’, namely a requirement for costeffectiveness evidence prior to reimbursement
of new drugs.
HunHTA Unit of Health Economics and Health Technology Assessment
Issues of the ‘Fourth Hurdle’ (Cont.)
• Do we request evidence for all new drugs, or just
some?
• How do we prioritize drugs for assessment?
• Does it make sense to assess several drugs in the same
class together?
• How prescriptive, or flexible, should we be in
specifying the data requirements?
• Should we be willing to accept data from other
jurisdictions? If so, which?
HunHTA Unit of Health Economics and Health Technology Assessment
!
104 application
between May 1th- September 1st, 2004
for HTA appraisal
105/89/EEC Transparency Directive
HunHTA Unit of Health Economics and Health Technology Assessment
HTA settings and capacity
HunHTA - INAHTA, Corvinus University of Budapest
•
4 staff - 4 trained (MD, economists)
•
HTA assessment capacity / year: 4-5 HTA reports
•
limitation: number of trained personnel
•
budget for HTA: occasionally based on the given HTA project
ESKI - Office of HTA National Institute for Strategic Health
Research, Ministry of Health Social and Family Affairs
•
7 staff - 2 trained (2 MDs, 3 economists, 1 chemist)
•
HTA assessment capacity / year: ?
•
limitation: ?
•
Budget for HTA: ? / not yet decided
HunHTA Unit of Health Economics and Health Technology Assessment
Please notice …
• Manufacturers are unlikely to tailor many
evaluations to the needs of the 10 ‘New’ EU member
states.
HunHTA Unit of Health Economics and Health Technology Assessment
Summary - Challenges
• Data shortage: no valid data available on morbidity, health
status, risk, quality of life (measurement methodology is used
in a very limited scale yet); registries are non-existing or
inappropriately managed – real epidemiology is unknown.
• Cost & costing: costs are unknown or misleading
(reimbursement), costing guideline has not established yet.
• The major constraint is the availability of trained personnel
• Standardisation of health economic analysis and HTA is
needed in order to improve adaptability and transferability of
the studies to other settings.
HunHTA Unit of Health Economics and Health Technology Assessment