Programme line 1
Comprehensive assessments of health interventions & evidence-based health services research
HTA can now look back on 20 years of methodological developments and international harmonization. "Traditional" assessments answer questions on new/innovative or established medical interventions such as
• Is the intervention effective, does it work?
• For whom, which subgroup of patients?
• At what cost?
• How does the intervention compare with alternatives?
Unlike traditional HTA, evidence-based health services are still young, but are based on the same basic research principles: systematic literature search and analysis, transparent presentation of sources, process and results and interdisciplinary perspectives. In contrast to the results from the critical appraisal of medical interventions, the results from health services research are deeply anchored in the health systems concerned and cannot be transferred as easily into other systems. The research field of evidence-based planning follows the approach of distinguishing between demand and need and of critically questioning the actual utilisation of health services.
For this reason, the LBI-HTA as an HTA institute in a small country is devoted to bringing international HTA into our national context and to further developing methods of evidence-based health services research.
Programme line 2
Scientific support of health policy and decision-maker networks
Policy-relevant decisions are traditionally reached on the basis of a consensus of high-ranking experts in boards and committees. This process of exclusively expert-based (so-called eminence-based) decision-making is highly prone to bias, conflict of interests and doctrine. It is the aim of the evidence-based support of decision-making to collect and present recent research results and to provide a more rational and transparent input to the process of health policy decision-making independent of influences from interest groups. The aim is to shape the process in the long term by systematically questioning marketed information and by asking for sound evidence.
It is the task of the scientific support of health policy and decision-maker networks to react rapidly to demand and to present the evidence in a transparent and readable format to decision-makers.
Programme co-ordination: Claudia Wild
Health Technology Assessment in hospitals
The informal "HTA in hospitals" network consists of a group of about 20 high-ranking decision-makers (medical directors and quality managers) from nearly all Austrian hospital cooperations. The network meets 3 times a year (October, February, June) in order to receive informational HTA input into 4 prevailing topics, to discuss them and to exchange ideas on regulatory and reimbursement issues.
The task of the LBI-HTA is to coordinate the meetings, to ask for and to collect current topics and to prepare the presentations. The format of the meetings is to present each topic from the HTA perspective, to have it presented by an invited clinical expert and to lead subsequently into a structured discussion.
Contact: Claudia Wild
Scientific decision support of Health Ministry
It is the task of the LBI-HTA to provide - on request - scientific support to different committees of the Austrian health ministry (BMG):
• to support the Medical Advisory Group for the maintenance of the Austrian medical procedure classification (Austrian DRG Catalogue) with evidence analysis of new/innovative or established medical interventions
• to react to information enquiries in the Supreme Health Council (advisory committee of the Health Minister)
Contact: Claudia Wild
Programme line 3
Public understanding and research transfer
Quite often the demand for new/innovative health care interventions emerges - enforced by early media coverage - even before market approval or reimbursement. "Public understanding", which is firstly the transfer of knowledge about market forces and about methods for critically questioning the evidence presented on effectiveness and cost-effectiveness, appropriateness and secondly methodological support for differentiating between new and innovative interventions, is meant to be a contribution to a better understanding of true effectiveness and at the same time to a democratic shaping of benefit packages.
The intention of "public understanding and research transfer" is to build up - through presentations, seminars, monthly newsletter, user-friendly webpage and search support - a critical mass of patients, journalists, representatives of the health administration, academia etc. that questions the information presented and asks for sound evidence before decision making.
Programme co-ordination: Judit Erdös
Programme line 4
HTA-implementation: development and informing on effective policy instruments
Evidence for the effectiveness and cost-effectiveness of numerous technologies and interventions can often be presented only after market approval and use under real clinical conditions for some years. Then, even ineffective technologies are widely spread and applied. Since it is ethically not justifiable to withhold true medical innovations from patients, and because pseudo-innovations absorb a lot of resources, it is increasingly considered to take new technologies under "surveillance" or "limited application" at specific medical centers. Consequently, final decisions on reimbursement are made only after patient-relevant outcome data become available.
Methods for limited application and the assessment and appraisal of technologies and interventions after having obtained patient-relevant outcome data are still young. In this programme line, they will be further developed and applied.
Programme-coordination: Anna Nachtnebel
Programme line 5
International cooperation / HTA Best Practice
International cooperation and collaboration, particularly within the European Un-ion, is becoming increasingly important in order to avoid redundancies in the as-sessment of medical technologies prior to reimbursement or inclusion in public benefit catalogues. Drugs that have been approved by the European regulatory authority EMA are being launched simultaneously in European markets. In addi-tion, medical products and technologies are being launched nearly at the same time in European markets.
The EU-project “EUnetHTA – European Network for Health Technology As-sessments” is concerned with the development and implementation of structures and networks for transnational HTA-cooperation. This project was funded by the EU from 2006 to 2008 and was continued without public funding throughout 2009. From 2010 until 2012, it is again being funded by the EU in the form of a Joint Action.
The LBI-HTA was co-initiator and has been a leading partner of EUnetHTA for several years. The LBI-HTA manages Work Package 7 in close cooperation with the French HAS/Haute Authorité de Santé. Work Package 7 is concerned with rapid exchange of information on the assessment of new technologies after their approval, but prior to their introduction on the market.