Skip to main content Accessibility help
×
Home
Hostname: page-component-5c569c448b-b4ls7 Total loading time: 0.362 Render date: 2022-07-06T10:20:18.219Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Evaluating HTA principles

Published online by Cambridge University Press:  13 October 2010

Peter J. Neumann
Affiliation:
Director, Center for the Evaluation of Value & Risk, in Health, Institute for Clinical Research and Health Policy Studies, 800 Washington Street, Tufts Medical Center, #063, Professor, Tufts University School of Medicine, Boston, Massachusetts 02111 Email: pneumann@tuftsmedicalcenter.org
Michael F. Drummond
Affiliation:
Professor, Health Economics, Centre for Health Economics, University of York, Alcuin A Block, Heslington, York YO10 5DD, United Kingdom Email: md18@york.ac.uk
Bengt Jonsson
Affiliation:
Professor, Department of Economics, Stockholm School of Economics, 65, Sveavagen, Stockholm, SE 11383Sweden Email: Bengt.Jonsson@hhs.se
Bryan R. Luce
Affiliation:
Senior Vice President, Department of Science Policy, United BioSource Corporation, 7101 Wisconsin Avenue, Suite 600, Bethesda, Maryland 20817 Email: bryan.luce@unitedbiosource.com
J. Sanford Schwartz
Affiliation:
Leon Hess Professor of Medicine, Health Management & Economics, Departments of Medicine and Health Care Management, School of Medicine and the Wharton School, University of Pennsylvania, Blockley Hall Suite #1120, Philadelphia, Pennsylvania 19104 Email: schwartz@wharton.upenn.edu
Uwe Siebert
Affiliation:
Chair Professor of Public Health (UMIT), Department of Public Health, Medical Decision Making and Health Technology Assessment, UMIT – University for Health Sciences Medical Informatics and Technology, Eduard Wallnoefer Center I, Hall i.T., Austria, A-6060, Adjunct Professor, Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115 Email: public-health@umit.at
Sean D. Sullivan
Affiliation:
Professor, Pharmaceutical Outcomes Research and Policy Program, University of Washington, 1959 NE Pacific Avenue, Box 357630, Seattle, Washington 98195 Email: sdsull@u.washington.edu
Rights & Permissions[Opens in a new window]

Extract

Thank you for the opportunity to respond to the letter by Gibson and Little. The authors raise several points that require a response. First, they claim that we inaccurately characterized the DERP/Washington State Medicaid agency, and did not appreciate that the DERP and the Washington State Medicaid agency have different missions. On the contrary, however, we fully recognized that DERP's mission is to conduct systematic reviews and not to make recommendations, whereas Washington State uses the reviews in making recommendations for their Medicaid enrollees. We specifically noted in the study that “Washington Medicaid is one of fourteen participants in the DERP. DERP researchers conduct health technology assessments for drug classes. Participants in the DERP, such as the Washington Medicaid program, retain local authority for interpreting DERP reports and for decision making regarding which drugs to pay for.” We chose to analyze DERP/Washington State as a single entity for our exercise because we were interested in analyzing the link between the HTA conducted and the decisions that follow them.

Type
LETTERS TO THE EDITOR
Copyright
Copyright © Cambridge University Press 2010

To the Editor:

Thank you for the opportunity to respond to the letter by Gibson and Little. The authors raise several points that require a response. First, they claim that we inaccurately characterized the DERP/Washington State Medicaid agency, and did not appreciate that the DERP and the Washington State Medicaid agency have different missions. On the contrary, however, we fully recognized that DERP's mission is to conduct systematic reviews and not to make recommendations, whereas Washington State uses the reviews in making recommendations for their Medicaid enrollees. We specifically noted in the study that “Washington Medicaid is one of fourteen participants in the DERP. DERP researchers conduct health technology assessments for drug classes. Participants in the DERP, such as the Washington Medicaid program, retain local authority for interpreting DERP reports and for decision making regarding which drugs to pay for.” We chose to analyze DERP/Washington State as a single entity for our exercise because we were interested in analyzing the link between the HTA conducted and the decisions that follow them.

Second, Gibson and Little state that we applied our principles in an ad hoc way and should have labeled it as a commentary. In fact, we stated clearly and prominently in the abstract of the article and in text itself that our piece was intended as a commentary. Moreover, we emphasized that our study was intended as a first-blush effort to analyze the support and use of the Key Principles for HTA, and that our focus was on uptake and use of the Principles, rather than a verdict or report card on the HTA entities evaluated. We emphasized that our goal was to advance the practice of HTA and to stimulate informed discussion through an extended and interactive process. Indeed, we view the Gibson and Little letter, despite their criticism, as a symbol of some success in this regard. In addition, several of the other organizations featured in the study contacted us directly with positive feedback, even if they did not agree with all of our observations. In some cases, our study provoked a debate about the key principles within these organizations.

Third, regarding whether the DERP/Washington State supports certain principles, such as explicitly characterizing uncertainty or considering issues of generalizability and transferability, we stick to our judgments, but recognize, as we did in our study, that there is room for debate on such matters. Our study acknowledges that there is subjectivity in our evaluations and that other researchers or the agencies themselves may be more or less strict about whether a particular principle has been supported or implemented. In some cases, we judged our assessments to be more or less straightforward, while in others the evaluation required greater discretion, and caused considerable debate within the group.

Fourth, we agree with Gibson and Little that work on validation of the key principles is warranted. We stressed in our study that in the future researchers might also consider how to undertake formal benchmarking exercises. We stated that it would be useful to pre-specify and quantify more precisely the criteria for achieving a positive verdict on support and use of the principles, and that some principles will lend themselves more readily to such benchmarking than others.

Finally, regarding any use of our study by industry lobbyists in Oregon and Washington, none of us had any involvement in, nor prior awareness of, those efforts.

You have Access
2
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Evaluating HTA principles
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Evaluating HTA principles
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Evaluating HTA principles
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *