HT2 - The Introduction of Health Technology Assessment in Japan; Lessons Learned from Three Other New HTA Markets (Brazil, Poland and South Korea)

Abstract

The introduction of Health Technology Assessment (HTA) is currently being trialled in Japan on a number of products with expected results in April 2018. The government plans to implement a full-scale HTA system for reimbursement and pricing decisions. This research aims to inform successful HTA implementation based on the experience of other relatively new HTA markets. The evolution of the HTA systems and processes in Brazil, Poland and South Korea were analysed based on publically available information. These three countries were chosen because of their relatively new introduction of HTA and recognition as leaders in their respective region. Brazil introduced HTA in 2006 and strengthened its role with the National Committee for Health Technology Incorporation (CONITEC) in 2011. Poland created the Agency for Health Technology Assessment (AOMTiT) in 2005. South Korea has required HTA via the Health Insurance Review and Assessment (HIRA) since 2007. Despite differences in HTA implementation, the role of HTA in the decision-making process has increased in the three markets, with the number of assessments performed rising. However, HTA implementation first slowed down the adoption of innovative technologies and changes or exemptions were introduced over time to improve patient access. In all three countries, the HTA process has evolved substantially with the introduction of methodological guidelines, clarification of the process and enhanced transparency. The experiences in Brazil, Poland and South Korea, where limited resources are available, have demonstrated the interest of introducing HTA in reimbursement and pricing decision-making. However it seems that a stepwise, transparent approach is necessary to guarantee success, as well as the establishment of clear guidelines adapted to local context. Certain therapies might benefit from special consideration as cost-effectiveness thresholds are often inappropriate for rare diseases or conditions with short life expectancy, resulting in reduced patient access in those areas.