Health technology assessment (HTA) has long been employed by many countries around the world, but its adoption in Asia has been slower. Only recently have a growing number of Asian countries started to implement HTA for pricing and reimbursement decisions. The objective of this article is to provide an overview of how HTA has been or is being implemented in Asia within the context of a country's existing—and often complex—coverage, reimbursement, and pricing schemes. Three countries at different stages of HTA implementation were selected as case studies: South Korea, where there is a young yet established HTA program; Japan, where a 3-year HTA pilot program has just concluded; and China, where HTA efforts are underway but have not been formally implemented. Not only do the experiences of these 3 countries well exemplify how the organization and scope of HTA can be customized to meet a country's unique healthcare needs, but they also provide the opportunity to outline some common key challenges that must be overcome to implement and develop HTA competencies and capabilities.
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Initial efforts to introduce HTA in China were made in the 1990s and mostly consisted of research projects and activities conducted at local universities within research units established by the Minister of Health. 47,48 HTA activity substantially increased in the mid-2000s, when more advanced but costly medical technologies (such as a magnetic resonance imaging) were introduced. 47 HTA was still perceived as research versus as a healthcare policy tool, although interest in HTA continued to increase steadily. In 2008, several government-led HTA initiatives were undertaken under the auspices of the China National Health Development Research Center (CNHDRC) with the goal of informing healthcare policy decisions, and in 2010, the CNHDRC organized a National HTA Forum. 49 Since then, efforts to further develop and expand HTA capabilities have noticeably intensified, as evidenced by the increase in the number of HTA-related publications and projects funded by the National Natural Science Foundation. 47 For example, HTA was applied to assess the economic impact of antiviral therapies for hepatitis B and C, and budget impact analyses of pneumococcal and human papillomavirus vaccines were performed. 47 In 2016, the China Health Policy and Technology Assessment Network—comprising 29 agencies, universities, hospitals, and professional associations—was established by the CNHDRC to develop HTA capacity and expertise. 49,50 Guidelines to strengthen the implementation of HTA were also issued, starting with the publication in 2015 of the China Guidelines for Pharmacoeconomic Evaluations. 47 In 2018, a nationwide task force initiated a formal update of these guidelines, with the final guidelines expected to be released in 2019.
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- global healthcare systems
- health technology assessment
- value assessment