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Keep Calm and Carry On: Inahta Members' Views On KEEP CALM AND CARRY ON: INAHTA MEMBERS’ VIEWS ON PLANNING FOR POTENTIALLY DISRUPTIVE TECHNOLOGIES HTAi Annual Meeting 18 June 2019 in Cologne, Germany www.inahta.org ABOUT INAHTA International Network of Agencies for HTA Founded in 1993. Now a global network of 51 agencies (2019). Member agencies support health system decision making that affects over 1 billion people in 32 countries. Agencies by region: • 31Europe • 5 Latin America • 5 Canada & USA • 5 Asia • 3 Australia & New Zealand • 2 Africa Agencies by country economic status: • 41 in high income countries • 1 in upper-middle income countries • 2 in lower-middle income countries www.inahta.org INAHTA MEMBERS All INAHTA members are publicly-funded HTA agencies that: . Assess technology in health care . Are non-profit organizations . Relate to a regional or national government . Are funded at least 50% by public sources . Provide access to publicly- available reports to other members upon request www.inahta.org INAHTA BOARD OF DIRECTORS 2018/19 Dr. Sophie Söderholm Werkö Prof. Tracy Merlin SBU, Sweden AHTA, Australia Chair Vice Chair Dr. Matthias Perleth Dr. Mouna Jameleddine G-BA, Germany INASanté, Tunisia Treasurer Director Dr. Young Sung Lee Mrs. Debjani (Jani) Mueller NECA, Korea CMeRC, South Africa Director Director Ex officio members Dr. Brian O'Rourke Dr. Yingyao Chen Dr. Michelle Mujoomdar CADTH, Canada, Past Chair HTAi Board Observer CADTH, Canada Dr. Christopher McCabe IHE, Canada Director Head of Secretariat www.inahta.org INAHTA’S MISSION INAHTA connects and empowers national and regional HTA agencies to create better health policy around the globe. INAHTA´s mission is to: . Bring agency leadership and expertise to the global HTA community to advance the science and practice of HTA. Demonstrate the value of HTA agencies as key components of modern health systems to support robust decision-making based on the best available scientific evidence. Support best practice and innovation for building and maintaining thriving HTA agencies. Enable continuous exchange of knowledge and learning among member agencies. www.inahta.org GLOBAL COLLABORATION Memoranda of understanding with: • WHO • HTAi • EUnetHTA • HTAsiaLink • RedETSA • G-I-N • EuroScan www.inahta.org CONTACT INAHTA www.inahta.org Secretariat Executive Manager: Tara Schuller Tel (Canada): +1 780 401 1770 Email: [email protected] www.inahta.org PANEL SESSION OVERVIEW 1. Summary of INAHTA World Café on disruptive technologies Dr. Michelle Mujoomdar, CADTH, Canada 2. HTA agency experiences evaluating disruptive technologies KEEP CALM AND CARRY ON: INAHTA Susanna Axelson, SBU, Sweden MEMBERS’ VIEWS ON 3. Challenges with genetic diagnosis and PLANNING FOR screening POTENTIALLY Dr. Li Ying (Grace) Huang, CDE, Taiwan, DISRUPTIVE Republic of China TECHNOLOGIES 4. Challenges of anticipating & evaluating HTAi Annual Meeting disruptive technologies 18 June 2019 in Cologne, Dr. Rossella Di Bidino, UVT-Gemelli, Italy Germany 5. Looking back at disruptive technologies – what made them disruptive? Dr. Claudia Wild, LBI-HTA, Austria 6. Q&A, discussion Moderator: Ken Bond, IHE, Canada www.inahta.org THANK YOU ! www.inahta.org Secretariat Executive Manager: Tara Schuller Tel (Canada): +1 780 401 1770 Email: [email protected] www.inahta.org World Café on Disruptive Technologies: Reflections from the 2018 INAHTA Congress Michelle Mujoomdar, PhD HTAi 2019 18 June 2019 Disclosure • Funded by federal, provincial, and territorial ministries of health. • Application fees for three programs: • CADTH Common Drug Review (CDR) • CADTH pan-Canadian Oncology Drug Review (pCODR) • CADTH Scientific Advice 1 Disclosure - individual • Engaged as an individual external expert: • EC (June 2017 – Aug 2017; May 2018 – Aug 2018) • ZIN (April 2018 – May 2018) • Advisory roles for several IMI projects • PREFER (travel expenses paid by University of Uppsala) • PARADIGM (travel expenses paid by HTAi and European Patients’ Forum) • EHDEN (coordinated through Erasmus University) • Other travel expenses paid by CIRS (Sept 2018) and CIHR grants on which CADTH is a knowledge user (March 2019 and May 2019) 2 World Café Methodology • Related to the concept of “group intelligence” • A topic of mutual interest is discussed in small groups • At least 3 x 20-minute rounds, each round with a different question or focus • At the end of each round, participants move to next table • Building knowledge – we are “Wiser Together” 3 Groups / Areas of Focus per round • Pharmaceuticals • Devices / medtech • Public Health / screening / other 4 Objectives 1. Develop an common understanding of what a “disruptive health technology” is and how it is different from incremental technology. 2. Compile examples of disruptive medicines, devices/procedures, and screening/prevention technologies. 3. Develop recommendations for how HTA agencies should deal with disruptive technologies in the three areas. 4. Determine if there are any special considerations to be given to disruptive technologies (i.e., sources of evidence) and raise any other issues or ways of thinking about these disruptive technologies. 5 Findings • ATMPs / cell and gene therapy • ‘curative’ therapies • Artificial Intelligence • 3D-printing • Next generation sequencing • Cannabis • Mobile apps – self-monitoring • Self-testing • Tissue engineering, bionic limbs 6 Findings • Change • Change in the way that patients are treated, change in system, workforce • Doesn’t “fit” into current way of working • Potentially results in disinvestment • HTA agencies need to shift from reactive to proactive • Life-cycle approach • Additional data collection, reassessment • Social, ethical, legal, environmental, and privacy considerations 7 Plan Forward • Prioritised the topic of disruptive technologies for a Position Statement by INAHTA • INAHTA Task Group formed • Criteria on how HTA agencies can define a disruptive technology and manage it from an assessment point of view • Draft statement available for consultation with INAHTA members by end of 2019 8 9 SWEDISH AGENCY FOR HEALTH TECHNOLOGY ASSESSMENT AND ASSESSMENT OF SOCIAL SERVICES Disruptive technologies panel session Cologne June 2019 Susanna Axelsson, SBU A disruptive technology in healthcare impacts: • Patient outcomes • Care pathway • Healthcare delivery system • Payment mechanisms Example • Testing for human papilloma virus (HPV) can replace cytology as screening test for cervical cancer – Machine analysis – Easy to standardize – Expected lower costs Report from SBU, guidelines from NBHW • Health care delivery system and Care pathway • Longer ”protection”, 6 compared to 4 years for cytology • Patient outcomes • Better sensitivity • Payment outcomes • Lower costs (NBHW) HTA and disruptive technologies • Stakeholders along the technology lifecycle work together • Patient involvement • Dynamic assessment procedures • Early Reassessment • Need for real world evidence to show progress and maintain access – The National Quality Register for Prevention of Cervical Cancer • Monitoring and follow-up of the process and effect Evidence generation • HTA community should advocate the need for proper clinical evidence to allow access • Evidence can be accelerated and timely generated • Evidence generation plan, e.g. parallel consultation (scientific advice) involving various decision-makers to ensure evidence generation meets different needs • Preparedness of patient registries to collect relevant information in a robust manner (post-licensing evidence) Key elements • Need for proper clinical evidence, robust data (RCT) to allow access • Joint assessments supposed to accelerate access • A dynamic assessment procedure • Real world evidence required to confirm the initial assessment SWEDISH AGENCY FOR HEALTH TECHNOLOGY ASSESSMENT AND ASSESSMENT OF SOCIAL SERVICES Keep Calm and Carry On: INAHTA Members’ Views on Planning for Potentially Disruptive Technologies- Diagnostic and Screening HTA Disruptive technologies session Panel Grace Li-Ying Huang, PhD Director, Division of Health Technology Assessment Center For Drug Evaluation, Taiwan View our website: http://nihta.cde.org.tw/ June 18, 2019 Disclaimer • This presentation was not officially cleared, and the views offered here do not necessarily represent the official positions at MOHW, including NHIA. Outline • Development of HTA in Taiwan • Genomic analysis into routine care? • Potentially Disruptive Technologies in HTA Development of HTA in Taiwan • Since 2007, Taiwan began conducting health technology assessments (HTA) to support National Health Insurance Administration (NHIA)’s reimbursement decisions for drugs. • HTA’s extension to: – medical devices in 2011 – medical services in 2014 – social care in 2016 • The Division of HTA operates under the Center of Drug Evaluation (CDE), Taiwan. Int J Technol Assess Health Care. 2019 Feb 28:1-5. doi: 10.1017/S0266462319000011. [Epub ahead of print] About the Disruptive Technologies idea in HTA – Focus on Diagnostic and Screening 5 Genomic analysis into routine care? • In UK, Health and Social Care announces ambition to sequence 5 million genomes within five years. • Genomics England working with the NHS to introduce genomic analysis into routine care, with rare disease and cancer patients receiving diagnoses that lay the foundation for more effective treatments. • In sequencing up to 5 million genomes in the next five years, understanding of the link between genetic information and the risk of disease will grow, bringing new discoveries, new awareness and wider benefits to patients, and deliver
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