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Kce.fgov.be Federaal Kenniscentrum voor de Gezondheidszorg Centre fédéral d’expertise des soins de santé Belgian Health Care Knowledge Centre Health Technology.

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Presentation on theme: "Kce.fgov.be Federaal Kenniscentrum voor de Gezondheidszorg Centre fédéral d’expertise des soins de santé Belgian Health Care Knowledge Centre Health Technology."— Presentation transcript:

1 kce.fgov.be Federaal Kenniscentrum voor de Gezondheidszorg Centre fédéral d’expertise des soins de santé Belgian Health Care Knowledge Centre Health Technology Assessment in Internationaal Perspectief Raf Mertens, MD General Director KCE

2 kce.fgov.be KCE Federaal Kenniscentrum voor de Gezondheidszorg Centre fédéral d’expertise des soins de santé Opdracht: studies uitvoeren en rapporten maken om de beleidsmakers te adviseren bij hun beslissingen inzake gezondheidszorg en ziekteverzekering. Aanbevelingen formuleren voor goede klinische praktijk. 2

3 kce.fgov.be Het KCE team 3 Totaal: 55 Directie: 4 staff: 7 secretariaat: 7 experten: 33 artsen economisten data analysten juridisch experten sociologen statistici ….

4 kce.fgov.be From proposal to published KCE report Pre-project fiche (PPF) Project fiche Start of procedures meeting experts Pre-report validation Report Publication report on website; Press release Validation by Board Work programme Accepted by Board Study proposal Evaluation by KC E Identify team (int or ext) ; if external : Public call for tender 100 –

5 kce.fgov.be Een paar voorbeelden… Is Neonatale Screening op Mucoviscidose aangewezen in België? Een eerste stap naar het meten van de performantie van het Belgische gezondheidszorgsysteem Kosteneffectiviteit van antivirale behandeling voor chronische hepatitis B in België. Gebruik van point-of care systemen bij patiënten met orale anticoagulatie: een Health Technology Assesment Terugbetaling van Radioisotopen in België Organisatie en financiering van genetische diagnostiek in België 5 HSR - GCP - HTA

6 kce.fgov.be International collaboration In Health Services Research

7 kce.fgov.be International collaboration In Guidelines Development

8 kce.fgov.be HTA is a multidisciplinary process that summarises information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value Despite its policy goals, HTA must always be firmly rooted in research and the scientific method What is HTA ?

9 kce.fgov.be Questions to KCE Does A work better than placebo ? → Efficacy Does A work better than B ? → Relative efficacy … also in real life ? → Relative effictiveness at an acceptable cost ? → Cost-effectiveness 9

10 kce.fgov.be 10 + IVI Less EffectiveMore effective More cost -+ Effectiveness IIIII Less Effective More effective Less cost - Costs Cost-effectiveness Incremental cost-effectiveness ratio (ICER)

11 kce.fgov.be EfficacyEffectiveness Absolute Relative Versus best alternative Versus any alternative Versus placebo No comparator Ideal worldReal worldReal world trial trial no trial RCT vs. placebo RCT vs. best alternative - clinical outcome RCT vs. Any alternative - surrogate marker outcome Post marketing study with comparator Medical claims data Absolute efficacy Relative effectiveness Adapted from :Pharmaceutical forum (pragmatic trials, effectiveness trias)

12 kce.fgov.be 12 International Network of Agencies for Health Technology Assessment

13 kce.fgov.be European context 13

14 kce.fgov.be 14 EUnetHTA Joint action Work Package 4: Core HTA Work Package 5: Relative effectiveness Duplication of efforts ! avoid

15 kce.fgov.be 15 EUnetHTA Core HTA

16 kce.fgov.be 16 Social aspects Health problem and current use of technology Technical characteristics Ethical analysis Organisational aspects Legal aspects Clinical effectiveness Costs and economic evaluation Safety Domains of HTA Identified in previous EU projects, particularly EUR-ASSESS and ECHTA/ECAHI Promote the multidisciplinary nature of HTA Social aspects

17 kce.fgov.be 17 Clinical effectiveness Topics Health problem and current use of technology Technical characteristics Ethical analysis Organisational aspects Social aspects Legal aspects Costs and economic evaluation Safety Topic 1: Mortality Topic 2: Morbidity Topic 3 etc… Clinical effectiveness Issue 1: What is the effect of the intervention on overall mortality? Issue 2: What is the effect of the intervention on mortality caused by the target disease? Issue 3: etc…

18 kce.fgov.be 18 Core HTA Structure 18

19 kce.fgov.be 19 WP4 Strand A: HTA Core Model development – Online Tool & Service : production, publication, retrieval of HTA information – Policies for selecting Core HTA topics, production and publication of Core HTAs – New application of HTA Core Model on screening – Adaptation processes (building on earlier work EUnetHTA ) WP4 Strand B: Core HTA production – Production of 2 Core HTAs on jointly selected topics – Definition / testing of collaborative models in producing Core HTAs – Analysis of topic selection processes and stakeholder involvement among agencies EUnetHTA JA WP4 Core HTA Key tasks

20 kce.fgov.be 20 Online version available at Currently for EUnetHTA member agencies only

21 kce.fgov.be 21 What will HTA Core Model enable? 1.For HTA agencies and professionals – Core HTAs to support local HTAs – Other building blocks for local HTAs – International collaboration (sharing resources, expertise and methods) – Greater variability of HTA information available (through reduction of overlapping work) 2.For health care decision-makers – Better informed decisions through improved evidence-base – Better ROI on HTA through reduced overlapping work in different countries

22 kce.fgov.be 22 EUnetHTA JA WP6 Information Management System: Objectives Provision of a contemporary information management system which ensures compatibility and interoperability across WPs’ tools to support collaborative HTA work, and ensure rapid dissemination of HTA results within the JA 22

23 kce.fgov.be 23 Context HTA Glossary HTAi vortal HTA database E-meeting facility EIFFEL Planned & Ongoing Project (POP) HTA Core Model MO site Public Site News aggregator Adaptation glossary

24 kce.fgov.be 24 EUnetHTA JA WP6 Information Management System: Key tasks Some examples… 24

25 kce.fgov.be 25 Members-Only site 25

26 kce.fgov.be 26 Tools supporting day to day collaboration 26 Collab. tools E-meeting Work rooms Toolbar

27 kce.fgov.be 27 The future of HTA in Europe (draft) Directive on patients’ rights in cross-border healthcare - Article 15 on HTA collaboration Future role of the European Medicines Agency (EMA) SANCO work programme and the future of EUnetHTA Actual, practical collaboration between HTA agencies 27

28 kce.fgov.be Federaal Kenniscentrum voor de Gezondheidszorg Centre fédéral d’expertise des soins de santé Belgian Health Care Knowledge Centre Thanks for the attention! 28


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