Health Technology Assessment (HTA) Services
AHTA is an applied research group with national and international reputation in Health Technology Assessment (HTA).
What is a Health Technology?
"An intervention developed to prevent, diagnose or treat medical conditions; promote health; provide rehabilitation; or organise healthcare delivery.
- The intervention can be a test, device, medicine, procedure, program or system."
What is Health Technology Assessment (HTA)?
Health Technology Assessment (HTA) is "a multidisciplinary process that uses explicit methods to determine the value of a health technology at different points in its lifecycle. The purpose is to inform decision-making to promote an equitable, efficient and high-quality health system."
- "The HTA process is formal, systematic and transparent, and uses state-of-the-art methods to consider the best available evidence.
- The dimensions of value for a health technology may be assessed by examining the intended and unintended consequences of using a health technology compared to existing alternatives. These dimensions often include clinical effectiveness, safety, costs and economic implications, ethical, social, cultural and legal issues, organisational and environmental aspects, as well as a wider implications for the patients, relatives, caregivers and the population. The overall value may vary depending on the perspective taken, the stakeholders involved, and the decision context.
- HTA can be applied at different points in the lifecycle of a health technology, i.e. pre-market, during market approval, post-market, through to the disinvestment of a health technology."
Services we can provide:
- Health care evaluation
AHTA conduct systematic literature reviews and economic modelling to help policy makers know which health care practices are safe, effective and good value-for-money. Health care interventions considered include:
The systematic reviews we produce aim to:
- Investigational tests for diagnosis, screening, monitoring or staging of diseases;
- Therapeutic interventions such as surgical procedures or medical devices; or
- Combinations of tests and interventions (co-dependent technologies).
The economic modelling considers all the associated costs, savings, health benefits and harms of the intervention - including long-term consequences - and compares these to current clinical practice. This estimates the overall value-for-money of the intervention.
- Identify all the relevant literature describing studies on a given topic;
- Appraise the quality of the studies to determine the reliability of the results; and
- Synthesise the results of the studies to decide whether the health intervention is better or worse for patients than existing alternatives.
These health care evaluations help to inform Australian Government policy on a variety of topics.
- Pharmaceutical evaluation
We critique submissions from industry that are seeking public funding of medicines. The technologies under evaluation include:
The following aspects of the technologies are rigorously evaluated:
- Co-dependent technologies (i.e. test-drug combintations)
- Appropriate clinical place
- Comparative treatment effect
- Comparative safety
- Predicted use and financial impact on Government budgets
We also review classes of medicines as part of post-market surveillance activities - examples include a review of statins and of orphan drugs for rare diseases.
- Horizon scanning
AHTA can prepare assessments on new and emerging technologies to help inform policy makers about their impact on public health systems. A technology may be identified for assessment for reasons including, but not limited to:
- Obvious safety concerns
- Lack of previous assessment, despite rapid diffusion throughout the health system
- Clinical impact which is applicable to a large proportion of the population, or to a small proportion of the population, but with obvious and far-reaching benefits.
AHTA has an established record of expertise in horizon scanning and has contributed to the International Information Network on New and Emerging Health Technologies. Our activities have assisted in the exchange of information on emerging medical devices, surgical procedures and health care programmes.
Under the Australian Government's Comprehensive Management Framework for the Medicare Benefits Schedule (MBS), AHTA are contracted to review services that are publicly funded on the MBS to ensure they are safe, effective and appropriately used, and represent value-for-money. The reviews:
- Are undertaken using an evidence-based process;
- Are conducted in consultation with key stakeholders including consumers and medical professionals;
- Recognise that MBS funding should align with contemporary evidence, ensuring appropriate patient groups receive best clinical practice.
Further information is available here.
- Methodological research
Our team conduct methodological research that has impacted on the way HTA and clinical practice guideline development is undertaken internationally, including:
- Methods for evaluating the safety, effectiveness and cost-effectiveness of diagnostic tests;
- Methods for producing and grading recommendations in evidence-based clinical practice guidelines; and
- Methods for assessing co-dependent technologies (personalised medicines) and pharmaceuticals for reimbursement decisions.
AHTA completed the revision of Guidelines for Industry Submissions to the Pharmaceutical Benefits Advisory Committee.
- Guideline development
AHTA work with professional groups to help develop clinical practice guidelines. AHTA conduct systematic literature reviews to identify best practice in terms of prevention, diagnosis, and treatment of a health issue. Under the National Health and Medical Research Council (NHMRC) process for developing guidelines, the evidence assessment must consider:
The evidence informs the guidelines, which are then subjected to public and professional scrutiny before being accepted. More information on the NHMRC guidelines process is available here.
- Evidence base (number and type of studies and their quality)
- Consistency of the evidence
- Clinical impact
- Generalisability of the evidence (does is match the population and clinical setting)
- Applicability of the evidence (can it be applied to the Australian setting)
- Ethics Consulting
Ethics Consulting is available to researchers who want intensive support in thinking through ethical issues. This would be most valuable prior to submitting a Human Research Ethics Committee (HREC) application or after being denied HREC approval.
Advice would be offered on the following:
- What are the potential ethical issues?
- How does the research stand in relation to the National Statement on Ethical Conduct in Human Research?
- How might the research be better designed to deal with the ethical issues?
- Does the research need HREC approval?
This service is led by Dr Drew Carter, Research Fellow (Ethics). Dr Carter has conducted ethics research and teaching in the School of Public Health since 2009 and has led the teaching of ethics to the University's medical students since 2015. He is also the Ethicist member of the SA Health Human Research Ethics Committee (HREC).
More information about this service, including a schedule of fees, is available here.
- Integrated Research Support
Integrated Research Support is a comprehensive service that includes advice on research fundamentals including research design, methods and ethical issues. Integrated support of this kind is rare. AHTA is well placed to offer it, since AHTA employs experts in ethics, pharmaceutical and health care evaluation, health economics, biostatistics, and data management. It could be especially valuable to researchers designing clinical trials, for example. AHTA can also advise on research involving qualitative and deliberative methods.
For more information about AHTA's services, please email us.