ABSTRACT

Introduction

Heterogeneity in methods of economic evaluation makes the use of health technology assessment (HTA) evidence difficult. Thereby, several countries including India have developed their own standard guidelines for conducting HTAs. However, diverse HTA studies involving drugs, medical devices, health programs, and platforms require an adaptation of the standard methods.

Areas Covered

This review presents the specific characteristics of HTAs involving medical devices and health programs requiring adaptation of the standard guidelines. We use recent HTA studies in India to illustrate specific issues. These considerations involve the nature of decision-making problems, multiple scenarios in case of health programs, and specific attention to costing and the valuation of consequences. In case of medical devices, we discuss the issue of costing application of devices, multiple usage, learning curve for achieving effects, long causal path for health outcomes, and the issue of valuing false positives.

Expert Opinion

While standard guidelines are essential, specific features of health programs and medical devices need to be considered while undertaking HTAs. Additionally, the context in which the HTA is being undertaken, characteristics of the health system, methods of financing healthcare, and demand-side characteristics of healthcare utilization should be reflected in the HTA for health programs and medical devices.

中文翻译：

---

调整药物、医疗器械和健康计划的健康技术评估：来自印度经验的方法论考虑

摘要

介绍

经济评估方法的异质性使得卫生技术评估 (HTA) 证据的使用变得困难。因此，包括印度在内的几个国家制定了自己的 HTA 标准指南。然而，涉及药物、医疗设备、健康计划和平台的各种 HTA 研究需要对标准方法进行调整。

涵盖的领域

本综述介绍了 HTA 的具体特征，涉及需要调整标准指南的医疗器械和健康计划。我们使用印度最近的 HTA 研究来说明具体问题。这些考虑因素包括决策问题的性质、卫生项目的多种情况，以及对成本计算和后果评估的特别关注。对于医疗设备，我们讨论了设备应用成本、多次使用、实现效果的学习曲线、健康结果的长因果路径以及评估误报的问题。

专家意见

虽然标准指南是必不可少的，但在进行 HTA 时需要考虑健康计划和医疗设备的具体特征。此外，HTA 实施的背景、卫生系统的特点、医疗保健融资方法以及医疗保健利用的需求方特征应反映在健康计划和医疗器械的 HTA 中。