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University of Exeter Medical School

Evidence to Decision: Health Technology Assessment, Health Policy and Resource Allocation

Module titleEvidence to Decision: Health Technology Assessment, Health Policy and Resource Allocation
Module codeHPDM136
Academic year2022/3
Credits15
Module staff

Professor G.J. Melendez-Torres (Convenor)

Professor Christopher Hyde (Convenor)

Louise Crathorne (Convenor)

Duration: Term123
Duration: Weeks

4

Module description

 

In any healthcare system operating with finite resources, decisions need to be made about how resources are allocated. Health technology assessment (HTA) helps to prioritise these needs.
HTA is the assessment of relevant evidence and knowledge on the effects and consequences of healthcare technologies to guide decisions regarding the appropriate use of technology and efficient allocation of resources. It involves a multi-disciplinary assessment of the clinical, economic, ethical, legal and societal perspectives that may be impacted by the introduction of a new technology.
In this module you can expect to learn how to apply the core principles of HTA and understand the role and perspective of different stakeholders involved in the appraisal process. Technology appraisals conducted by the National Institute of Health and Care Excellence (NICE) in England will be used as examples.
This module permits students to attend some or all of the face to face lectures and workshops either in person or online. Learning will also be consolidated by self directed learning resources and ELE activities.

Module aims - intentions of the module

This course will focus on the application of core principles of HTA covering its key stages and decision-making process.

 

At the end of the course you will:

  • Understand the principles of HTA and why it is important
  • Understand how health economics, statistics, evidence, modelling and patient-reported outcomes guide the principles of health technology assessment
  • Understand how to assess the evidence in context of the decision problem for an HTA

Understand the perspective and requirements of different stakeholders involved in the HTA process

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

  • 1. Critically evaluate challenges and uncertainty in decision-making
  • 2. Apply evidence-based practices to evaluation and policy-making
  • 3. Use scientific evidence, best practices, or stakeholder input to inform policy and program decision-making

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

  • 4. Explain basic principles of healthcare resource allocation
  • 5. Understand methods used to evaluate health technologies

ILO: Personal and key skills

On successfully completing the module you will be able to...

  • 6. Perform effectively in a multidisciplinary team setting
  • 7. Communicate audience-appropriate content (e.g. for appraisal committee), both in writing and through oral presentation

Syllabus plan

Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:

  1. HTA component parts:
    1. Decision problem
    2. Evidence synthesis – clinical and cost-effectiveness
    3. Economic evaluation: cost effectiveness analysis and budget impact
    4. Stakeholder perspective: HTA agencies and decision making principles, identification of key issues and HTA in health system contexts
    5. Stakeholder perspective: Evidence Review or Assessment Group and critical appraisal, identification of key issues in evidence to decision and rigour and generalisability
    6. Stakeholder perspective: Committee and deliberation and uncertainty

Mock Appraisal Committee meeting: decision-making in practice

Learning activities and teaching methods (given in hours of study time)

Scheduled Learning and Teaching ActivitiesGuided independent studyPlacement / study abroad
271230

Details of learning activities and teaching methods

CategoryHours of study timeDescription
Scheduled learning and teaching activities27Delivered over 4.5 full days, each with 6 hours interactive student seminar sessions, including lecture, workshop-oriented activities lectures, table top exercises, group discussions and problem based learning, with the final half-day devoted to a mock appraisal committee meeting
Guided independent study93Session preparation and follow up work utilising resources provided on ELE
Guided independent study30Reading and assignment preparation

Formative assessment

Form of assessmentSize of the assessment (eg length / duration)ILOs assessedFeedback method
Mock Appraisal Committee2.5 hoursAllInstructor comment
Group exercises15 to 30 minutes per exerciseAllInstructor comment

Summative assessment (% of credit)

CourseworkWritten examsPractical exams
10000

Details of summative assessment

Form of assessment% of creditSize of the assessment (eg length / duration)ILOs assessedFeedback method
Essay: appraisal consultation document1002500 words1-7Written instructor comments
0
0
0
0
0

Details of re-assessment (where required by referral or deferral)

Original form of assessmentForm of re-assessmentILOs re-assessedTimescale for re-assessment
Essay: appraisal consultation document (100%)2500 words1-7Within 6 weeks

Re-assessment notes

Please refer to the TQA section on Referral/Deferral: http://as.exeter.ac.uk/academic-policy-standards/tqa-manual/aph/consequenceoffailure/

Indicative learning resources - Basic reading

: (*key readings)

 

Allen N, Pichler F, Wang T, Patel S, Salek S. Development of archetypes for non-ranking classification and comparison of European National Health Technology Assessment systems. Health Policy 113(3): 305-312.

 

*Busse R, Orvain J, Velasco M, Perleth M, Drummond M, Gurtner F, Jorgenseon T, Jovell A, Malone J, Ruther A, Wild C. Best practice in undertaking and reporting health technology assessments. Working Group 54 Report. Int J Technol Assess Health Care 2002; 18:361-472.

 

Chase D, Milne R, Stein K, Stevens A. What are the relative merits of the sources used to identify potential research priorities for the NHS HTA programme? Int J Technol Assess Health Care 2000; 16:743-750.

 

*Drummond, M. F., Schwartz, J. S., Jönsson, B., Luce, B. R., Neumann, P. J., Siebert, U., & Sullivan, S. D. (2008). Key principles for the improved conduct of health technology assessments for resource allocation decisions. International journal of technology assessment in health care, 24(3); 244-258.

 

Drummond M, Neumann P, Jonsson B. Can we reliably benchmark health technology assessment organizations? Int J Health Technol Assess Care 2012; 28(2): 159-165.

 

*Mathes T, Jacobs E, Morfeld J-C, Pieper D. Methods of international health technology assessment agencies for economic evaluations- a comparative analysis. BMC Health Services Research 2013; 371

 

Noorani HZ, Husereau DR, Boudreau R, Skidmore B. Priority setting for health technology assessments: a systematic review of current practical approaches. Int J Health Technol Assess Health Care 2007; 23:310-315.

 

*Petrou S, Gray A. Economic evaluation using decision analytical modelling: design, conduct, analysis and reporting. BMJ 2011; 342:d1766.

 

Richardson J, Schlander M. Health technology assessment (HTA) and economic evaluation: efficiency or fairness first. Journal of Market Access and Health Policy 2019; 7:1.

 

*Stephens JM, Hanke B, Doshi JA (on behalf of the HTA Principles Working Group, part of the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] HTA Special Interest Group). International survey of methods used in heath technology assessment (HTA): does practice meet the principles proposed for good research? Comparative Effectiveness Research 2012; 2: 29-44.

 

Indicative learning resources - Web based and electronic resources

European Network of Health Technology Assessment Available at: https://eunethta.eu/ (last accessed April 2020)

 

Health Technology Assessment International Available at: https://htai.org/ (last accessed April 2020)

 

International Network of Agencies for Health Technology Assessment Available at: http://www.inahta.org/ (last accessed April 2020)

 

National Institute for Health and Care Excellence. Guide to the Methods of Technology Appraisal. London: NICE, 2013 Available at: https://www.nice.org.uk/process/pmg9/chapter/foreword (last accessed April 2020)

 

What is health technology assessment? Available at: https://www.whatisseries.co.uk/hta/ (last accessed April 2020)

 

What are the HTA processes in the UK? Available at: https://www.whatisseries.co.uk/hta-processes-uk/ (last accessed April 2020)

Key words search

Health technology assessment; HTA agency; decision-making; economic evaluation; health policy; health services research

Credit value15
Module ECTS

7.5

Module pre-requisites

None

Module co-requisites

None

NQF level (module)

7

Available as distance learning?

No

Origin date

01/05/2020

Last revision date

01/02/2023