Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-12-06T17:25:52.686Z Has data issue: false hasContentIssue false

Economic evaluations conducted by Canadian health technology assessment agencies: Where do we stand?

Published online by Cambridge University Press:  01 October 2008

Jean-Eric Tarride
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Catherine Elizabeth McCarron
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Morgan Lim
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
James M. Bowen
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Gord Blackhouse
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Robert Hopkins
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Daria O'Reilly
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Feng Xie
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton
Ron Goeree
Affiliation:
McMaster University/St. Joseph's Healthcare Hamilton

Abstract

Objectives: To examine the production of Health Technology Assessments (HTAs) with economic evaluations (EEs) conducted by Canadian HTA agencies.

Methods: This research used a three-step approach: (i) the Web sites of five Canadian organizations promoting HTA were searched to identify HTA reports with EEs; (ii) HTA agencies were surveyed to verify that our information was complete with respect to HTA activities and to describe the factors that influence the HTA process in Canada (i.e., selection of HTA topics, execution, dissemination of results and future trends); (iii) HTAs with EEs were appraised in terms of study design, retrieval of clinical and economic evidence, resource utilization and costing, effectiveness measures, treatment of uncertainty as well as presence of a budget impact analysis (BIA), and policy recommendations.

Results: Two hundred forty-nine HTA reports were identified of which 19 percent included EEs (n = 48). Decision analytic techniques were used in approximately 75 percent of the forty-eight EEs and probabilistic sensitivity analyses were commonly used by all agencies to deal with parameter uncertainty. BIAs or policy recommendations were given in 50 percent of the evaluations. Differences between agencies were observed in terms of selection of topics, focus of assessment and production of HTA (e.g., in-house activities). Major barriers to the conduct of HTAs with EEs were capacity, a lack of interest by decision makers and a lack of robust clinical information.

Conclusions: The results of this research point to the need for increased HTA training, collaboration, evidence synthesis, and use of pragmatic “real world” evaluations.

Type
GENERAL ESSAYS
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Borowski, HZ, Brehaut, J, Hailey, D. Linking evidence from health technology assessments to policy and decision making: The Alberta model. Int J Technol Assess Health Care. 2007;23:155161.CrossRefGoogle ScholarPubMed
2. Canadian Agency for Drugs and Technologies in Health. Guidelines for the economic evaluation of health technologies: Canada. 3rd ed. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006. http://www.cadth.ca/media/pdf/186_EconomicGuidelines_e.pdf.Google Scholar
3. Drummond, MF, Jefferson, TO. Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ. 1996;313:275283.CrossRefGoogle Scholar
4. Drummond, M, Sculpher, M, Torrance, G, O'Brien, B, Stoddart, G. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005.CrossRefGoogle Scholar
5. Goeree, R, Levin, L. Building bridges between academic research and policy formulation: The PRUFE framework – an integral part of Ontario's evidence-based HTPA process. Pharmacoeconomics. 2006;24:11431156.CrossRefGoogle ScholarPubMed
6. Health Canada. Health Technology Assessment Task Group. Health technology strategy 1.0 final report. June 2004. http://www.cadth.ca/media/corporate/planning_documents/health_tech_strategy_1.0_nov2004_e.pdf.Google Scholar
7. Hivon, M, Lehoux, P, Denis, JL, Tailliez, S. Use of health technology assessment in decision-making: Coresponsibility of users and producers? Int J Technol Assess Health Care. 2005;21:268275.CrossRefGoogle ScholarPubMed
8. Lehoux, P, Tailliez, S, Denis, JL, Hivon, M. Redefining health technology assessment in Canada: Diversification of products and contextualization of findings. Int J Technol Assess Health Care. 2004;20:325336.CrossRefGoogle ScholarPubMed
9. Levin, L, Goeree, R, Sikich, N et al. Establishing a comprehensive continuum from an evidentiary base to policy development for health technologies: The Ontario experience. Int J Technol Assess Health Care. 2007;23:299309.CrossRefGoogle ScholarPubMed
10. Menon, D, Topfer, LA. Health technology assessment in Canada. A decade in review. Int J Technol Assess Health Care. 2000;16:896902.CrossRefGoogle Scholar
11. van Velden, ME, Severens, JL, Novak, A. Economic evaluations of healthcare programmes and decision-making: The influence of economic evaluations on different healthcare decision-making levels. Pharmacoeconomics. 2005;23:10751082.CrossRefGoogle ScholarPubMed