1. Valuing Medical Technologies The Decision Maker Perspective

2. Historical Concerns with HTA  Traditional HTA takes too long (outdated before it is completed), technologies infiltrate the system before they are assessed  Delays policy decisions, impacting patient care  Insufficient Evidence – more research is almost always required  HTA capacity is inadequate to amount of new technologies developed  HTAs do not adequately address policy issues

3. Decision Making Environment  Evidence based decision making  ‘Common Sense’ vs Evidence  Simple solutions to complex problems?  Celebrity Advocacy  Individual Stories  Dr. Google: The internet as an information source  ‘Truthiness’ in Twitter and other Social Media  Studies indicate that patients tend to overestimate the benefits and underestimate the risks of new treatments  Public perceptions of Government  Sustainability

4. Challenges for Decision Makers  Timeliness of HTAs (and decisions)  Pressures  Providers  Research / Innovation and Economic Development  Advocacy groups  Oprah Effect  Media  Patient Centred – what matters to patients?  Uncertainty  Safety: ‘ Primum non nocere ’ ?

5. Challenges Specific to Non-Drug Technologies  Volume of medical devices  Level of evidence  Ethical concerns: rapid adoption vs long term evidence  Product life cycle and long term evidence  Lack of a Common Technology Review and/or ‘formularies’  technology infiltrating the system  Broader context and impacts of non-drug technologies (HR needs, training, credentialing, facility readiness)  Blended Costs  Technology is transcending across historical categories of Drugs, Non-Drugs and Information Technology  Innovation Gap

6. The BC Health Technology Review  Evidence informed decisions to ensure citizens receive the best health care that the province can afford.  Health Technology Assessment Committee  Multidisciplinary committee  HSSBC, Public, Professional Members, MOH, and HA  MCDA framework for recommendations  Joint HA and Ministry decision making  Rapid Reviews  Reassessment  Policy