Abstract
Most countries have healthcare resource constraints and it is easy to identify new health technologies as an area in need of resource management, particularly given that new health technologies usually increase rather than save costs. Resource constraints are even more noticeable in Asia than in other regions, with a comparatively greater speed of population aging and the development of health security systems. The healthcare industry and policy makers in Asia generally understand that rationing in healthcare delivery is inevitable and have come to accept health technology assessment (HTA) as a policy option.
The HTA policy framework is slowly penetrating Asia; South Korea was the first country to regulate the use of pharmacoeconomic evidence in drug reimbursement decision making. The South Korean HTA policy was initially a surprise in Asia in that the policy was suddenly introduced with a short period of preparation, but industry, researchers and policy makers both in- and outside of South Korea have come to accept it as necessary and logical.
Thailand and Taiwan have also taken steps towards using pharmacoeconomic evidence in HTA, while other Asian countries are planning to implement such policies. However, it could be some time before a legitimate pharmacoeconomic-based HTA policy is actually implemented in each country, and the course of action will vary depending on the policy culture, healthcare system and public trust in bureaucracy of each country.
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Notes
In a recent meeting,[3] nearly every country in Asia claimed that it has its own version of HTA in decision making, and that the HTA entity in their country is linked to government decision making inNMTreimbursement or in the drug formulary. However, what is missing commonly in those Asian countries’ HTA frameworks is the use of economic evaluation (pharmacoeconomic in the case of drugs). In other words, those Asian countries with HTA frameworks make decisions on the adoption and use of NMTs without specific consideration of cost effectiveness. In the case of drugs, therefore, most countries in Asia concede that the use of pharmacoeconomicbased HTA is the focus of their policy changes in the years coming.
Although submission of pharmacoeconomic results for new drug reimbursement decisions is still not compulsory in Taiwan, it is interesting to observe that pharmacoeconomic results accompany most of the applications, likely with the expectation that decisions will be more favorable towards the product if pharmacoeconomic results are included. The only difference among applications is the level of pharmacoeconomic evidence included.[17]
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Yang, BM. The Future of Health Technology Assessment in Healthcare Decision Making in Asia. Pharmacoeconomics 27, 891–901 (2009). https://doi.org/10.2165/11310280-000000000-00000
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DOI: https://doi.org/10.2165/11310280-000000000-00000