Objective

Our paper aims to present Budget Impact Analysis (BIA) guidelines for health technology assessment (HTA) in India.

Methodology

A Systematic Literature Review (SLR) was conducted to retrieve information on existing BIA guidelines internationally. The initial set of principles for India were put together based on an interactive process between authors, taking into consideration the existing evidence on BIA and features of Indian healthcare system. These were reviewed by Technical Appraisal Committee (TAC) of Health Technology Assessment in India (HTAIn) for their inputs. Three rounds of consultations were held before finalising the guidelines. Finally, user feedback on the draft guidelines was obtained from the policy makers and programme managers involved in the budgeting decisions.

Results

We recommend a payer’s perspective, which will include both a multi-payer (depicting the current situation in India) and a single-payer scenario (which reflects a futuristic universal health care situation). A time horizon of 1–4 years is recommended. For estimation of eligible population, a top-down approach is considered appropriate. The future and current mix of interventions should be analysed for different utilisation and coverage patterns. We do not recommend discounting; however, inflation adjustments should be performed. The presentation of results should include total and disaggregated results, segregated year-wise throughout the chosen time horizon, as well as segregated by the type of resources. Deterministic sensitivity analysis and scenario analysis are recommended to address uncertainty.

Conclusion

Our recommendations, which are tailored for the Indian healthcare and financing context, aim to promote consistency and transparency in the conduct as well as reporting of the BIA. BIA should be used along with evidence from economic evaluation for decision making, and not as a substitute to evidence on value for money.

中文翻译：

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印度卫生技术评估预算影响分析的国家方法指南

客观的

我们的论文旨在介绍印度卫生技术评估 (HTA) 的预算影响分析 (BIA) 指南。

方法

进行了系统文献回顾 (SLR) 以检索国际上现有 BIA 指南的信息。印度最初的一套原则是基于作者之间的互动过程而结合起来的，同时考虑了关于 BIA 的现有证据和印度医疗保健系统的特点。这些内容由印度卫生技术评估技术评估委员会 (TAC) (HTAIn) 进行了审查，以获取他们的意见。在最终确定准则之前进行了三轮磋商。最后，用户对指南草案的反馈是从参与预算决策的政策制定者和项目经理那里获得的。

结果

我们建议从付款人的角度来看，其中将包括多付款人（描述印度当前的情况）和单一付款人情景（反映未来的全民医疗保健情况）。建议时间跨度为 1-4 年。对于合格人口的估计，自上而下的方法被认为是合适的。应针对不同的利用和覆盖模式分析未来和当前的干预组合。我们不建议打折；但是，应进行通货膨胀调整。结果的呈现应包括总的和分类的结果，在整个选定的时间范围内按年分开，并按资源类型分开。建议使用确定性敏感性分析和情景分析来解决不确定性。

结论

我们的建议是针对印度医疗保健和融资环境量身定制的，旨在促进 BIA 行为和报告的一致性和透明度。BIA 应与来自经济评估的证据一起用于决策，而不是替代物有所值的证据。