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   Table of Contents      
PERSPECTIVE
Year : 2018  |  Volume : 148  |  Issue : 3  |  Page : 258-261

Department of Health Research-Health Technology Assessment (DHR-HTA) database: National prospective register of studies under HTAIn


Department of Health Research, Ministry of Health & Family Welfare, New Delhi 110 001, India

Date of Submission28-Aug-2018
Date of Web Publication13-Nov-2018

Correspondence Address:
Vijay Kumar Gauba
Department of Health Research, Ministry of Health & Family Welfare, New Delhi 110 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1613_18

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How to cite this article:
Jain S, Rajshekar K, Sohail A, Gauba VK. Department of Health Research-Health Technology Assessment (DHR-HTA) database: National prospective register of studies under HTAIn. Indian J Med Res 2018;148:258-61

How to cite this URL:
Jain S, Rajshekar K, Sohail A, Gauba VK. Department of Health Research-Health Technology Assessment (DHR-HTA) database: National prospective register of studies under HTAIn. Indian J Med Res [serial online] 2018 [cited 2018 Dec 11];148:258-61. Available from: http://www.ijmr.org.in/text.asp?2018/148/3/258/245288


   Universal Health Coverage (UHC) and Health Technology Assessment (HTA) Top


The government of India (GOI) is committed to provide universal health coverage to assure the availability of free and comprehensive primary healthcare services to its 1.2 billion population[1]. The challenging task of extending the healthcare services to each and every patient can only be achieved with optimal utilization of the resources available[2]. Therefore, it is required that decisions on resource allocation are policy relevant and evidence informed[2],[3]. The evidence-based decision-making involves clinical effectiveness, cost-effectiveness, budget impact, as well as ethical, social and political feasibility studies[4],[5]. Health technology assessment (HTA) is an internationally accepted tool to ensure that technology choice is participatory and is well guided by considerations of scientific evidence, safety, consideration on cost-effectiveness and social values[6],[7],[8].


   Establishment of Health Technology Assessment in India (HTAIn) Top


The HTA in India (HTAIn) previously known as Medical Technology Assessment Board (MTAB) was set up under the Department of Health Research (DHR), by Ministry of Health and Family Welfare (MoHFW), to help GOI in evidence-informed decision-making in healthcare[9]. HTAIn has been given the responsibility to conduct health technology assessment studies for the requests coming from central and State health ministry that includes systematic literature reviews, economic evaluations, primary costing as and when required, and measuring and valuing the health outcomes pertaining to that health technology. Along with clinical and cost effectiveness, the studies will also analyse evidences related to equity issues regarding the deployment of health technologies, that ensures efficient use of the limited health budget and provide people access to quality healthcare at minimum cost[10],[11].


   How HTAIn functions in India Top


HTAIn consists of three core bodies including HTAIn Secretariat, HTAIn Technical Appraisal Committee (TAC) and HTAIn Board. The HTAIn Secretariat works in collaboration with its identified technical partners (TPs) and regional resource hubs (RRHs) across India[12]. The requests for HTA study are first processed by HTAIn Secretariat experts and then allocated to TPs. TPs develop the study proposal and present the study to TAC members. Once approved by TAC members, a stakeholder consultation meeting is convened to inform and apprise all concerned stakeholders regarding the HTA study. After completion of the HTA study, outcomes of the study are again presented to TAC members and after approval by TAC, a second stakeholder's consultation meeting is convened to inform them about the study results and final recommendations. Finally, the study is put up to the HTAIn Board, and once approved by the Board, a policy brief along with the HTA outcome report is sent to the user department from where the request has originally come.


   Need of National HTA database Top


HTAIn has started functioning congruously in January 2017 in DHR. Since its beginning, requests for HTA studies started to come from different policymakers with topics from different divisions of the Union MoHFW, State MoHFW, Rashtriya Swasthya Bima Yojana, National Pharmaceutical Pricing Authority, National Health Mission, National innovation portal, etc. As HTAIn is now more than 1½ year old and there are more than 25 HTA topics under process, it is crucial to record all the information properly and systematically. To manage the HTA study related information by storing it systematically and to make the information available in public domain transparently, a national HTA database is initiated under DHR. The national HTA database will be available on DHR website and will be periodically updated [Figure 1].
Figure 1: Graphics representing the role of Health Technology Assessment (HTA) in Universal Health Coverage and need of HTA database in India.

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   Data collection Top


A common ‘HTA information sheet’ (HIS) will be developed to collect the data. This HIS will be used to record the information on each ongoing and completed HTA study in an organized manner. Specific information regarding each HTA study including HTA topics, study investigators, interventions and comparators, user department, decision taken by TAC, stakeholder's consultation will be collected. The scope for inclusion will be broad, encompassing any study designated as a HTA by the HTAIn Secretariat or by TPs. The national HTA database will be hosted by DHR and it will be made available on DHR website. The information on each HTA study will be periodically updated.


   Proposed overview of DHR-HTA database Top


The DHR-HTA database will provide free access to bibliographic information about ongoing and completed HTAs studies commissioned and undertaken across the nation under HTAIn, DHR. All the studies will be funded by DHR, MoHFW, India. This database will provide specific information regarding each HTA study. There are practical and scientific benefits of a freely accessible transparent database. It is thus envisaged that providing free access to HTA information will reduce unnecessary duplication and will help in preventing wasted effort and precious research funds. It will encourage global collaboration between researchers, increase transparency and improve quality.


   Other HTA databases worldwide Top


The National Institute for Health Research (NIHR) HTA database is the most comprehensive, international register and provides free access to bibliographic information about ongoing and published HTAs commissioned or undertaken by members of the International Network of Agencies for HTA (INAHTA) and other HTA organizations from around the world[13]. It is funded by the UK NIHR and is currently produced by the Centre for Reviews and Dissemination (CRD). NIHR database established in 1998 combined the HTA records identified by CRD and INAHTA's HTA reports[13]. A new Canadian search interface for the HTA database was launched in January 2015. The new interface was developed through collaboration between CRD and the Pan-Canadian HTA Collaborative Working Group that is now serving as a Canadian HTA Repository[14].

Another database is a recently developed the EUnetHTA Planned and Ongoing Projects (POP) database. This database is developed to help HTA agencies in sharing the information with each other on planned, ongoing or recently published projects conducted at the individual agency level. The tool is created and managed by LBI-HTA (Austria) and the database is developed and maintained by DIMDI (Germany). Access to the POP database is currently restricted to EUnetHTA Partners and Associates who contribute to the POP database[15].

Besides these, there are many national HTA databases such as in Australia[16], Thailand[17] and Singapore[18] that provides information on HTA studies in their respective countries.

India is a relatively younger member joining the worldwide HTA community, but being unique in its own diversity in terms of healthcare challenges and healthcare system will surely have a major impact. Although there have been many studies on cost-effectiveness analysis, economic evaluations, cost-utility studies, etc.[19],[20],[21],[22],[23], coming from different researchers in India, most of these studies have been conducted for academic purpose. HTAIn being a central government programme will bring such studies under a broader umbrella, where these studies will be more policy driven. The DHR-HTA database will be showcasing all these studies, and it will be informative not just for India but also for a wider HTA community spread worldwide.


   Conclusion Top


The DHR-HTA database will become a valuable resource for locating literature and information, which will be freely available from a single source. This database will enable funders and researchers to identify work already in progress and will help reduce unintended duplication of effort. The database will also serve as a one-point source for policymakers where they can have a quick glance at the website to have an idea about studies under process, which can later become a basis for new public health programmes. The database will also be helpful to private manufacturers and clinicians as keeping them well informed about what all-new interventions are being considered under different HTA studies. Open access of such a database will bring the much-required transparency in the field of research and development.

Financial support & sponsorship: None.

Conflicts of Interest: None.



 
   References Top

1.
Ministry of Health & Family Welfare, Government of India. National health policy, 2017. Department of Health & Family Welfare, Ministry of Health & Family Welfare, Government of India; 2018.  Back to cited text no. 1
    
2.
Claxton K, Sculpher M, Drummond M. A rational framework for decision making by the National Institute for Clinical Excellence (NICE). Lancet 2002; 360 : 711-5.  Back to cited text no. 2
    
3.
Chalkidou K, Lord J, Fischer A, Littlejohns P. Evidence-based decision making: When should we wait for more information? Health Aff (Millwood) 2008; 27 : 1642-53.  Back to cited text no. 3
    
4.
Helfand M. Incorporating information about cost-effectiveness into evidence-based decision-making: The evidence-based practice center (EPC) model. Med Care 2005; 43 : 33-43.  Back to cited text no. 4
    
5.
Dowie J. ‘Evidence-based’, ‘cost-effective’ and ‘preference-driven’ medicine: Decision analysis based medical decision making is the pre-requisite. J Health Serv Res Policy 1996; 1 : 104-13.  Back to cited text no. 5
    
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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.  Back to cited text no. 6
    
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Stevens A, Milne R. Health technology assessment in England and Wales. Int J Technol Assess Health Care 2004; 20 : 11-24.  Back to cited text no. 7
    
8.
Pwee K, Tong S, Chow W. Health technology assessment supports evidence-based decision-making in the changi general hospital marketplace exercise. Value Health 2016; 19 : A831-2.  Back to cited text no. 8
    
9.
Department of Health Research, Ministry of Health and Family Welfare, Government of India. Available from: https://www.dhr.gov.in/about-mtab, accessed on May 31, 2018.  Back to cited text no. 9
    
10.
Prinja S, Downey LE, Gauba VK, Swaminathan S. Health technology assessment for policy making in India: Current scenario and way forward. Pharmacoecon Open 2018; 2 : 1-3.  Back to cited text no. 10
    
11.
Downey LE, Mehndiratta A, Grover A, Gauba V, Sheikh K, Prinja S, et al. Institutionalising health technology assessment: Establishing the medical technology assessment board in India. BMJ Glob Health 2017; 2 : e000259.  Back to cited text no. 11
    
12.
Department of Health Research. Available from: https://dhr.gov.in/sites/default/files/eNewsletter/HTAIn-NewsLetter.html#book5/page1, accessed on August 28, 2018.  Back to cited text no. 12
    
13.
NIHR-HTA Database INAHTA. Available from: http://www.inahta.org/hta-tools-resources/database/, accessed on May 31, 2018.  Back to cited text no. 13
    
14.
HTA Database Canadian Search Interface CADTH.ca. Available from: https://www.cadth.ca/resources/hta-database-canadian-search-interface, accessed on May 31, 2018.  Back to cited text no. 14
    
15.
POP Database - EUnetHTA. Available from: https://www.eunethta.eu/pop-database/, accessed on May 31, 2018.  Back to cited text no. 15
    
16.
Department of Health, Australian Government. Pharmaceutical Benefits Scheme (PBS). Available at: http://www.pbs.gov.au/info/industry/listing/participants/pbac, accessed on August 28, 2018.  Back to cited text no. 16
    
17.
Kapol N, Maitreemit P, Chalongsuk R, Amrumpai Y, Sribundit N, Thavorncharoensap M, et al. Making health technology assessment information available for decision making: The development of a Thai database. J Med Assoc Thai 2008; 91 (Suppl 2) : S8-10.  Back to cited text no. 17
    
18.
Agency for Care Effectiveness, Ministry of Health, Singapore. Our Process & Methods. Available from: http://www.ace-hta.gov.sg/our-process-and-methods.html#health-technology, accessed on August 28, 2018.  Back to cited text no. 18
    
19.
Prinja S, Bahuguna P, Mohan P, Mazumder S, Taneja S, BhandariN, et al. Cost effectiveness of implementing integrated management of neonatal and childhood illnesses program in district Faridabad, India. PLoS One 2016; 11 : e0145043.  Back to cited text no. 19
    
20.
Prinja S, Nimesh R, Gupta A, Bahuguna P, Thakur JS, Gupta M, et al. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: A study protocol. Glob Health Action 2016; 9 : 31473.  Back to cited text no. 20
    
21.
Coleman PG, Goodman CA, Mills A. Rebound mortality and the cost-effectiveness of malaria control: Potential impact of increased mortality in late childhood following the introduction of insecticide treated nets. Trop Med Int Health 1999; 4 : 175-86.  Back to cited text no. 21
    
22.
Horton S, Sanghvi T, Phillips M, Fiedler J, Perez-Escamilla R, Lutter C, et al. Breastfeeding promotion and priority setting in health. Health Policy Plan 1996; 11 : 156-68.  Back to cited text no. 22
    
23.
Sinha RK, Haghparast-Bidgoli H, Tripathy PK, Nair N, Gope R, Rath S, et al. Economic evaluation of participatory learning and action with women's groups facilitated by Accredited Social Health Activists to improve birth outcomes in rural Eastern India. Cost Eff Resour Alloc 2017; 15 : 2.  Back to cited text no. 23
    


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