The most important facilitators and barriers to the use of Health Technology Assessment in Canada: a best-worst scaling approach.

Autor:	Wranik WD; Faculty of Management, School of Public Administration, Dalhousie University, Halifax, Canada.; Faculty of Medicine, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.; Jean Monnet European Union Centre of Excellence, Dalhousie University, Halifax, Canada., Székely RR; Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Mayer S; Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria., Hiligsmann M; Faculty of Health Medicine and Life Sciences, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands., Cheung KL; Health Behaviour Change Research Group, Department of Health Sciences, College of Health and Life Sciences, Brunel University London, London, UK.
Jazyk:	angličtina
Zdroj:	Journal of medical economics [J Med Econ] 2021 Jan-Dec; Vol. 24 (1), pp. 846-856.
DOI:	10.1080/13696998.2021.1946326
Abstrakt:	Background: Health Technology Assessment (HTA), which can support public drug reimbursement decisions will play a core function in the planned national Pharmacare program in Canada. To address existing barriers to the use of HTA, these must be ranked in order of priority. The goal of this study was to access the relative importance of known facilitators and barriers to the use of HTA in the context of the Canadian health care system, with attention to differences between regions and stakeholder groups. Methods: We used the best-worst scaling object case approach to elicit a quantitative ranking of a list of 20 facilitators and 22 barriers. A sample of 68 Canadian HTA stakeholders, including members of expert committees, decision/policymakers, researchers/academics, and others participated in the study. Their task was to identify the most important and the least important item in 12 sub-sets of five facilitators and 14 sub-sets of five barriers. Findings: Relative Importance Scores derived via hierarchical Bayes analysis revealed relations, engagement, and contact between stakeholders as most important on both the barrier and facilitator sides. Other top-ranked facilitators included the availably of credible and relevant research. Other top-ranked barriers included inconsistencies in the evidence and limited generalizability. The availability of HTA guidelines did not rank highly on either side. The main limitation of the study was the challenge with reaching the relevant respondents; this was mitigated by involving the national HTA agency in the research. Conclusion: Canadian stakeholders consider the relationships within the HTA network among the most important. Policies should focus on strengthening these relationships. Future research should focus on the connectivity and distribution of knowledge and power within the HTA network.
Databáze:	MEDLINE
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