Health technology assessment in Asia: an emerging trend
In this interview excerpt, originally published in the Journal of Comparative Effectiveness Research, Bong-min Yang (Seoul National University, Seoul, South Korea) discusses the development of health technology assessment in Asia.
You are a policy advisor to several other Asian countries. How widely does the use of HTA vary between these at present?
Formalizing health technology assessment (HTA) is a vivid trend when one looks at the HTA regulatory activities in Asia. Countries at the regulatory stage with at least one regulatory body include South Korea (Health Insurance Review and Assessment), Taiwan (Center for Drug Evaluation) and Thailand (Health Intervention and Technology Assessment Program). Korea is in a slightly more advanced phase with the recent refinement of its Pharmacoeconomic Guideline (PEG) to accommodate local data availability and methodological issues, although its basic HTA structure and methodology framework are intact. Countries at the intermediate stage include China, Japan and Singapore, where either PEG is developed (although yet to be adopted officially) or voluntarily submitted pharmacoeconomics and outcomes research (PE-OR) data are reviewed as part of decision-making.
You were involved in the introduction of a formal health technology assessment system in Korea; what was the most challenging aspect of this experience?
To meet the prevailing need for a system of resource allocation for newly introduced medical technologies, the health technology assessment (HTA) system of Korea was formally introduced in 2007. The introduction of the system itself was not a hugely challenging process. However, although anticipated in advance, the system faced several barriers in its practical implementation, among which two were prominent. First, effectiveness and efficacy data from our own population setting were not available in most cases, and neither were preference scores for Koreans. Because of this, the responsible party (government, research institute or pharmaceutical company) often relied upon foreign outcome data for domestic HTA data construction. As we all know, it would not be safe to use foreign outcome-related data without modifications, considering possible variations in genetics among races and in medical practice patterns among countries, which would result in different scales of effectiveness.