HTA roadmap for Egypt : Health Technology Assessment Roadmap and Implementation Action Plan for Egypt

Abstract

With the implementation of the health care reform in Egypt, the government will have high negotiation power due to the extended beneficiary coverage and expanding the benefits package, which can eventually help to improve the efficiency of resource allocation and maximize health outcomes. Health technology assessment (HTA) is an important tool to increase the evidence base of resource allocation decisions. Given the complex and fragmented structure of the Egyptian health care system, as well as the relatively low GDP per capita, differences in social values, it is not recommended to directly adopt decision-making practices from high-income countries - not even other middle-income countries (MICs) - without adjustment to local values and traditions. Despite benefiting from the experiences of others, Egypt needs to build up its own HTA architecture. Currently, HTA implementation is taking its first steps in Egypt with some visible achievements. The purpose of this study is to explore long-term objectives in HTA implementation in Egypt and propose specific actions over the next ten years. Evaluation of current and preferred status of HTA highlighted the most important gaps to set objectives for the HTA roadmap. Local experts validated the roadmap for feasibility and applicability, developing a chronological set of actions for HTA implementation in Egypt. National experts agreed that several actions are vital for HTA implementation in Egypt, including coordination between HTA bodies and strengthening local evidence generation. They also recommended using innovative tools like "multicriteria decision analysis (MCDA)" for procurement of health technologies and "managed entry agreements" for reimbursement of high-cost medicines. To implement these actions, investment in technical capacity building is indispensable. Most of the experts favored using multiple and soft cost-effectiveness thresholds for the value judgement of health technologies. Experts recommended that HTA should initially be used to assess innovative pharmaceuticals then expand the scope to cover other health technologies in the longer term.