Growing Application of Pharmacoeconomics and Outcomes Research in Health-Care Decision-Making in the Asia-Pacific Region

Abstract

Resource scarcity in health-care delivery, as in other sectors of the economy, is a globally common phenomenon. Among the contributing factors to resource scarcity in health care, prime factors are the introduction of new health technologies (NHT), an individual’s growing awareness of better health status, and population aging. Resulting issues from resource scarcity raise deep concerns for Asian policymakers and stakeholders in health care. With the recognition that market imperfection prevails with the use of NHT, a regulatory body may well intervene in the market of NHTs with the objective of establishing a standard for NHT adoption and the curtailing of nonrational use of NHTs. Based on the experiences of several Western economies, Asian communities have found much promise in the use of health technology assessment (HTA) as a policy tool for NHT management. Interest in HTA is significant in Asia, as was evidenced in the ISPOR 3rd Asia-Pacific Conference held in Seoul, Korea, in September 2008. With “Evidence-Based Health-Care DecisionMaking in Asia-Pacific: The Application of Pharmacoeconomics and Outcomes Research” as the theme, the Conference was well-received by active participants from mostly Asian countries. By and large, the attendees in HTA meetings can be grouped into two parties, one representing technology developers and the other representing those in research and policy. Interestingly, the two groups are coming to the meetings for the same reason—that HTA policy may well be adopted at their local settings sooner or later. Considering local resource constraints in health-care delivery in most countries, whether developed or developing, NHT can quickly be pinpointed as a promising area for resource management because unlike new technologies in other sectors, NHT are mostly cost-increasing rather than cost-saving. The majority in the field therefore believes that a type of rationing scheme with NHT is inevitable and should be implemented sooner than later. Resource constraint in health care is becoming even more prominent an issue in Asia than in other regions. NHT developers view Asia as very attractive for two reasons: first, it is already a big market with a large population size, and second, it is a growing market with relatively higher economic growth rates and comparatively greater speed of population aging. As HTA policy has been formulated in parts of the region in recent years, NHT developers have become keenly interested in their policy contents and their impact on business. By attending HTA meetings and exchanging dialogue, NHT developers hope to learn how to cope with the changes brought on by HTA adoption. Researchers and policymakers attend meetings to see what can be done in the context of their own country and how to improve ongoing policy situations. The understanding they commonly share as they attend HTA meetings is that rationing is inevitable, and that HTA could be an option now or some time in the future [1]. The implementation of HTA guidelines in a few Asian countries including South Korea, Taiwan, and Thailand in the last few years marks the catching up of Asia with the Western counterparts at a remarkable speed in the generation and utilization of health economic data. With the world’s attention becoming more and more focused in Asia, a phenomenon which is likely to continue for decades to come, it is only natural and legitimate that an evidence-based approach should be adopted in deciding health-care resource utilization. This is of utmost importance in providing a favorable environment for both the adoption of new HTAs as well as improving the standard of health care across Asia.