Abstract
IntroductionImplementation of health technology assessment (HTA) is still in an early stage with some heterogeneity in the Middle East and North Africa (MENA). Our objective was to assess the current and future status of HTA implementation in the MENA region by focusing on regional commonalities.MethodsPreparatory discussions for the first ISPOR conference in the MENA region indicated some potentially generalizable trends of HTA roadmaps. To widen the perspective, a policy survey was conducted among conference participants by applying an HTA implementation scorecard. Discussion group members helped to validate key conclusions during and after the conference.ResultsHealth policy experts in MENA countries would like to facilitate HTA implementation and expect significant changes with some generalizable directions in 10 years compared to the current status according. HTA capacity building has to be strengthened by more graduate and postgraduate programs. Increased public budget and enhanced institutionalization are necessary success factors of HTA implementation. The scope of HTA has to be extended from pharmaceuticals to non-pharmaceutical technologies and to revision of previous policy decisions. Although cost-effectiveness with explicit threshold remains the most preferred HTA criterion, several other criteria have to be considered, maybe even by applying an explicit MCDA framework. The role of local evidence and data has to be strengthened in MENA countries, which translates to the extended use of local patient registries and payers' databases. Duplication of efforts can be reduced if international collaboration is integrated into national HTA implementation.DiscussionOur results should be viewed as an initial step in a multi-stakeholder dialogue on HTA implementation. Each MENA country should develop its context-specific HTA roadmap, as such roadmaps are not transferable without taking into account country size, economic status, public health priorities and adopted systems of health care financing.
Highlights
Implementation of health technology assessment (HTA) is still in an early stage with some heterogeneity in the Middle East and North Africa (MENA)
The preferred status seems to be more homogenous, yet we have to take this with a grain of salt, the destination is similar, the route can be different from one country to another
It is not sufficient only to design the roadmap, constant monitoring of the Health Technology Assessment (HTA) implementation is recommended, which may necessitate the readjustment of timelines or even action items
Summary
Implementation of health technology assessment (HTA) is still in an early stage with some heterogeneity in the Middle East and North Africa (MENA). The economic status of countries in the Middle East and North Africa (MENA) are heterogenous, as the region includes some of the highest income countries globally alongside several low- and middle-income countries (Yorulmaz., 2016). In the recent era of lower oil prices, even high-income Gulf countries are forced to rethink their public policies, including health policies toward a more cost-conscious direction (Pharmaceuticals and Healthcare Outlook for 2017: Middle East & North Africa, 2016). Our objective was to provide an overview on the current status of HTA implementation in the Middle East and North Africa (MENA) region and to identify and recommend objectives for the 10 years by focusing on regional commonalities, and not on differences across countries
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