Abstract
This paper provides an update on the growing use of HTA in Asia and lessons for other countries seeking to advance HTA. This paper builds upon the research by Chootipongchaivat et al and the World Health Organization (WHO) identifying 18 “factors conducive to the development of HTA in Asia”. These factors were used to create a balanced scorecard to assess the progress of HTA. The authors scored the progress against each of the factors made in China, India, Indonesia, Malaysia, Philippines, South Korea, Taiwan, Thailand, and Vietnam. A scoring system on a scale of 1 to 5 was used wherein: 1=No progress on milestone; 2=milestone at early stages, ad hoc HTA use; 3=progress on milestone, routine HTA but limited impact; 4 = significant progress on milestone, routine HTA use but limited remit; and 5 = significant progress on milestone, routine HTA use that informs several decisions. Total scores indicated progress of HTA while milestone scores provided contextual insights within countries. A literature review and expert interviews were used to complete scorecards. South Korea and Thailand had highest scores of 73 and 71 points respectively, while Vietnam scored lowest at 28.5. Advanced HTA programs, such as Thailand and South Korea, have independent HTA agencies with a broad remit, explicit process and methods, network of researchers, and routine use of HTA. Countries like Taiwan and Malaysia fall in a middle tier, with established HTA programs with limited remit. The final tier consists of countries like China, India, Indonesia, Philippines, and Vietnam, emerging HTA processes. Universal Health Coverage (UHC) goals have catalyzed expansion of HTA. However, political will, technical expertise, and sustained financing remain challenges for sustainable HTA programs. While legislation supporting HTA is helpful, political will is key. Authors provide recommendations on areas for additional investments and opportunities for regional collaboration.
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