HTA Development Research Articles

Priority areas for the development of the health technology assessment system in Ukraine: survey results

The purpose of the study is to analyze the expert opinion on the priority areas of development of the HTA in Ukraine, taking into account the existing condition, problems and possible prospects for effective development. Materials and methods. The expert survey (online questionnaire) included the preparation of a special questionnaire, targeted selection of experts based on their competence in the field of HTA. Three groups of respondents took part in the survey, including 13 HTA developers, 32 users, and 31 informed persons to ensure the representativeness of the survey results. The following methods were used to process and interpret the results: scientific generalization, mathematical and statistical, analytical, and graphical. Results of the study. Based on the results of the expert survey, the role and place of the HTA in the health care system was determined. Experts see the main purpose of the HTA as preparing the necessary information of the relevant level of evidence for decision-making on the selection of optimal MTs (in particular, for budget procurement, inclusion in regulatory lists for price regulation and reimbursement). The respondents' opinions on the participation of different socio-professional groups in the implementation of the HTA and the use of its results were studied. Thus, according to the results of the survey, HTA experts and scientists can carry out the assessment, and in some cases (mini-HTA, hospital HTA for the formation of local formularies and protocols) – specialists of medical institutions. According to the respondents, it is advisable to expand the use of HTA results for decision-making at the national, regional and local levels. According to the survey, the priority areas for the development of HTA are the creation of a professional environment, adequate logistical and informational support, improvement of legislation, creation of an optimal institutional structure, harmonization of HTA methodology and development of international cooperation. Conclusions. The expert survey allowed us to determine the most likely scenario for the further development of HTA in Ukraine. According to the majority of respondents, the main efforts are currently focused on capacity building, formation of a professional environment, active use of evidence, and infrastructure development.

Mapping of health technology assessment in China: a comparative study between 2016 and 2021

BackgroundHealth Technology Assessment (HTA) in China has recently expanded from purely academic research to include policy or decision-oriented practice, especially after HTA evidence was used to update the National Reimbursement Drug List for the first time in 2017. This study aims to identify the progress and challenges of HTA development from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.MethodsWe conducted a cross-sectional web-based survey with policy makers, researchers and industry-providers in China in 2016 and 2021 respectively. The ‘Mapping of HTA Instrument’, was utilized to assess the HTA development across eight domains: Institutionalization, Identification, Priority setting, Assessment, Appraisal, Reporting, Dissemination of findings and conclusions, and Implementation in policy and practice. To reduce the influence of confounders and compare the mapping outcomes between the 2016 and 2021 groups, we conducted 1:1 Propensity Score Matching (PSM). Univariate analysis was conducted to compare the differences between the two groups. The overall results were further compared with those of a mapping study that included ten countries.ResultsIn total, 212 and 255 respondents completed the survey in 2016 and 2021, respectively. The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM (89.38 versus 83.96). Following PSM, 183 respondents from the 2016 and 2021 groups were matched. Overall, the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016 (P < 0.05). The Appraisal domain in 2021 was more explicit, transparent and replicable than that in 2016 (t = −3.279, P < 0.05). However, the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021 (P < 0.05).ConclusionsOur study suggest that the level of HTA development in China progressed significantly from 2016 to 2021. However, before engaging in HTA activities, further efforts are required to enhance the assessment process. For instance, it is important to establish a clear goal and scope for HTA; adapt standardized methodologies for evaluating the performance of systematic reviews or meta-analyses; and provide comprehensive descriptions of the safety, clinical effectiveness, cost, and cost-effectiveness of the assessed technologies, thus improving the development of HTA in China.

Is health technology assessment ready for generative pretrained transformer large language models? Report of a fishbowl inquiry.

The Health Technology Assessment International (HTAi) 2023 Annual Meeting included a novel "fishbowl" session intended to 1) probe the role of HTA in the emergence of generative pretrained transformer (GPT) large language models (LLMs) into health care and 2) demonstrate the semistructured, interactive fishbowl process applied to an emerging "hot topic" by diverse international participants. The fishbowl process is a format for conducting medium-to-large group discussions. Participants are separated into an inner group and an outer group on the periphery. The inner group responds to a set of questions, whereas the outer group listens actively. During the session, participants voluntarily enter and leave the inner group. The questions for this fishbowl were: What are current and potential future applications of GPT LLMs in health care? How can HTA assess intended and unintended impacts of GPT LLM applications in health care? How might GPT be used to improve HTA methodology? Participants offered approximately sixty responses across the three questions. Among the prominent themes were: improving operational efficiency, terminology and language, training and education, evidence synthesis, detecting and minimizing biases, stakeholder engagement, and recognizing and accounting for ethical, legal, and social implications. The interactive fishbowl format enabled the sharing of real-time input on how GPT LLMs and related disruptive technologies will influence what technologies will be assessed, how they will be assessed, and how they might be used to improve HTA. It offers novel perspectives from the HTA community and aligns with certain aspects of ongoing HTA and evidence framework development.

Fifteen Lessons from Fifteen Years of the Health Intervention and Technology Assessment Program in Thailand

ABSTRACT The Health Intervention and Technology Assessment Program (HITAP) was established in 2007. This article highlights 15 lessons from over 15 years of experience, noting five achievements about what HITAP has done well, five areas that it is currently working on, and five aims for work in the future. HITAP built capacity for HTA and linked research to policy and practice in Thailand. With collaborators from academic and policy spheres, HITAP has mobilized regional and global support, and developed global public goods to enhance the field of HTA. HITAP’s semi-autonomous structure has facilitated these changes, though they have not been without their challenges. HITAP aims to continue its work on HTA for public health interventions and disinvestments, effectively engaging with stakeholders and strategically managing its human resources. Moving forward, HITAP will develop and update global public goods on HTA, work on emerging topics such as early HTA, address issues in digital health, real-world evidence and equity, support HTA development globally, particularly in low-income settings, and seek to engage more effectively with the public. HITAP seeks to learn from its experience and invest in the areas identified so that it can grow sustainably. Its journey may be relevant to other countries and institutions that are interested in developing HTA programs.

Institutionalizing health technology assessment in Egypt: Situational analysis and roadmap.

Objective: To conduct a situational analysis with the aim to inform future health technology assessment efforts (HTA) in Egypt. Introduction: The Egyptian government has set universal health coverage as a 2030 target. Several agencies have been created in the context of the ongoing healthcare reform. The Egyptian Authority for Unified Procurement, Medical Supply and the Management of Medical Technology (UPA) is one of them and was established to support strategic procurement using HTA. Methods: Description of the development of HTA in Egypt supported by a literature search as part of a scoping exercise, and a stakeholder analysis and identification of HTA capacity survey, based on previous surveys, with relevant stakeholders conducted in 2022. This was followed by a stakeholder event where results were shared and further contextualized. Results: The UPA is expected to evaluate the cost-effectiveness of health technologies and public health programs. The HTA process is being developed, focusing on the assessment of the value of new pharmaceuticals being introduced to the Egyptian market. A total of 16 participants responded on behalf of their organizations to the stakeholder analysis and identification of HTA capacity survey. More than 80% of the respondents were familiar with current efforts conducted by UPA and strongly support the implementation of HTA in Egypt. Transparency was highlighted as an important criterion. Over 90% of the respondents mentioned economic analyses as an HTA product being developed in Egypt, and medicines were the type of technology that stakeholders ranked as first in the rank of health technologies that need the output from HTA urgently. Capability building and training were highlighted as areas in which further support is required. Conclusion: This study represents the first attempt to describe the current path for HTA in Egypt. There seems to be momentum in Egypt to proceed and advance with HTA institutionalization. It would be important that next steps are built on the skills and capabilities already in place in Egypt, ensure methods and processes are in place and up to date and involve the wider system in Egypt so stakeholders can appropriately contribute and participate in the HTA process.

HTA10 Update of the Health Technology Assessment Progress in Ukraine: Implementation and Impact in 2021

A significant stage in the development of HTA in Ukraine was the approval of the first Decree No1300 “On the approval of the procedure for the state HTA” by the Cabinet of Ministers of Ukraine on 23 December, 2020 and the approval of the first HTA Guideline “The state health technology assessment for medicines” by the Order of the MoH of Ukraine No593 on 29 March, 2021. The study aims to provide a review of HTA progress in 2021 in Ukraine.

Decision-making regulatory framework of the introduction of health technologies at the hospitals in Ukraine

The limited resources of the health care system and the COVID-19 pandemic encourage more rational and cost-effective administrative and clinical decisions. To achieve the best health care within available resources, the introduction of the most efficient technologies should be supported, considering organizational, social and ethical issues. Assessment of health technologies at different levels, namely national/regional and hospital, is becoming increasingly important. Adherence to cost-effective approaches to administrative and clinical decision-making will ensure the rational use of the state budget and improve clinical outcomes, improve the quality and life expectancy of patients.&#x0D; The purpose of the study was to analyze the current regulatory framework for the introduction of health technologies (medicines and medical devices) at the hospital level. During the research the methods of content analysis, historical, system-analytical, generalization was used.&#x0D; According to the analysis of the decision-making regulatory framework for the health technology’s introduction, it was drawn the next conclusions. The active HTA development in Ukraine is noted. In a short time, a legal framework for state HTA for medicines was created and approved, amendments were made to the Law of Ukraine ‘On Public Procurement’ and other Ukraine’s laws on medicine procurement under managed entry agreements, the further steps for development of the HTA ecosystem in Ukraine were identified.&#x0D; The legal framework for the circulation of medical devices needs to be updated in Ukraine, starting with technical regulations in accordance with EU regulations №745 and №746 and further approval of the Law on Medical Devices.&#x0D; Procedures for evaluation and selection of medicines and medical devices at the level of medical institutions are absent in Ukraine and require separate elaboration. The introduction of HB-HTA will help hospital managers to make independent, transparent, reasonable, and impartial management decisions on the selection of drugs and medical devices.&#x0D; The obtained results prove the need for further research of everyday decision-making practices on the introduction of health technologies at the hospitals, development of methodology for hospital-based HTA and update regulation of HB-HTA in the current legal framework of Ukraine.

OP181 Adapting Evidence To Produce A Health Technology Assessment Of Mammography Screening: An Example From The West Bank

IntroductionHealth technology assessment (HTA) can play a key role in evidence-based decision-making. However, HTA requires resources that might be lacking in low-income settings. To test the feasibility of adapting existing evidence as part of the HTA process, this project evaluated the effectiveness and economic impact of breast cancer screening programs for women over 40 years in the West Bank, where mammography screening is provided for free in governmental clinics.MethodsWe conducted a search for systematic reviews, HTAs and guidelines in electronic databases. We included the most recent global systematic review and meta-analysis that fulfilled our inclusion criteria. The European Network for Health Technology Assessment (EUnetHTA) adaptation toolkit was used to guide adaptation and undertake a budget impact analysis of the economic impact of mammography screening. We build capacity by working as a team of HTA experts and first-time HTA researchers. The results were disseminated to raise awareness for HTA.ResultsThe European Commission Guidelines on Breast Cancer Screening were identified as most recent global systematic review with meta-analyses, out of 2,365 references. The adapted evidence may inform policies on screening in the West Bank. Our experience is that adaption requires extensive skills and resources, including finding, assessing, and adapting relevant evidence. The EUnetHTA toolkit is useful, but also adds to the workload. Furthermore, local stakeholder engagement is important in topic selection, to access information, and to contextualize global evidence to the local setting.ConclusionsThis study is currently ongoing, but preliminary findings show that producing an HTA by adapting existing evidence in resource-limited settings is feasible. There is a need for nuanced guidance on transferability of evidence from other settings. Future studies should investigate innovative methods to optimize the adaption process. Capacity building in adaptation is important to ensure the production of quality HTA products. Inclusion of local team members and stakeholders is important for future development of HTA in the region.

PNS72 Charting the Progress of HTA in Asia: Are We Ready for Evidence Based Decision-Making?

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.

TOTUM-854 PREVENTS L-NAME-INDUCED ARTERIAL HYPERTENSION IN MICE

Objective: Arterial Hypertension (HTA) is a major cause of premature death worldwide, with an estimated global prevalence of 1.13 billion people. Polyphenolic compounds have been shown promising effects in the context of HTA management. We have developed Totum-854 (T-854), a polyphenol-rich botanical composition to reduce the risk of developing AHT. We assessed the chronic effect of T-854 on preventing the development of N(G)-Nitro-L-arginine-methyl ester (L-NAME)-induced AHT in mice. Design and method: Twelve-week-old C57Bl6/J mice were divided into 3 groups: Control (n = 11), L-NAME (n = 11), and L-NAME + T-854 (n = 11). L-NAME (100 mg/kg/day) was dissolved in drinking water. Mice were gavaged once a day for three weeks with either T-854 (450 mg/kg) or vehicle. The arterial pressure was assessed using the CODA® Tail-Cuff System every week for three weeks. Effects of T-854 on in vitro angiotensin-converting enzyme (ACE) activity was also assessed by a HPLC-UV method. Results: Body weight evolution was not significantly different between the 3 groups over the study period. As expected, L-NAME increased systolic (SBP; from 105 ± 3 to 130 ± 1 mmHg, p &lt; 0.0001), diastolic (DBP; from 77 ± 3 to 97 ± 2 mmHg, p &lt; 0.0001) and mean (MBP; from 86 ± 3 to 108 ± 2 mmHg, p &lt; 0.0001) blood pressure along the 3 weeks of treatment. Interestingly, in T-854-supplemented mice, SBP was significantly reduced from the first week of supplementation and DBP and MDP from the second week of supplementation. After three weeks of supplementation, T-854 lowered the SBP by 16% (p &lt; 0.0001), the DBP by 20% (p &lt; 0.05) and the MBP by 18 % (p &lt; 0.01), in comparison to L-NAME mice. Moreover, in vitro experiments showed an inhibitory effect of T-854 on ACE activity. Conclusions: In conclusion, this study showed that T-854 prevents L-NAME-induced HTA in mice. ACE inhibition may partly explain the preventive effects of T-854 on HTA development in this model. T-854 is a promising new approach for the prevention of HTA.

Establishing a national HTA program for medical devices in Italy: Overhauling a fragmented system to ensure value and equal access to new medical technologies

Differing contexts have greatly influenced HTA development in various countries, with considerable effort recently made by international HTA networks (e.g., EUnetHTA) and the European Union (EU) to make HTA a more coherent, equal, and efficient process. Medical devices (MDs) present particular challenges for HTA because of frequent, rapid innovation, outcomes influenced by end-user competence, dynamic pricing and often low-quality scientific evidence. Our objective is to describe the development, structure and governance of a National HTA Program for MDs (PNHTADM) in Italy, a highly participatory, stakeholder-engaged, evidence-based process to reform a fragmented system of appraisal and approval. Based largely on EUnetHTA methods, the resulting process delineates a standardized system for proposing MDs by any stakeholders, accrediting HTA producers, setting criteria for prioritization and appraisals, and innovatively linking recommendations with coverage, reimbursement and procurement of MDs. Expected benefits include reduced disparities in pricing and reimbursement policies and improved access to new technologies across 21 regional healthcare systems in Italy's decentralized, universal system, complete with provisions to require additional evidence collection and centrally monitor diffusion. Though devised for Italy, the design, resources and underlying analysis provide a framework for other nations seeking to consolidate HTA initiatives, particularly in light of new EU regulation.

PNS118 DEVELOPMENT AND POTENTIALS OF HEALTH TECHNOLOGY ASSESSMENT SYSTEM IN KAZAKHSTAN.

Renovation of the post-Soviet healthcare system required further drastic transformations of the deep-rooted principles, especially in terms of healthcare funding issues and decision-making. Since 2009 Kazakhstan has started introducing of HTA, as a part of the joint project between the Government and World Bank. This study aims to define existing challenges of health policy and policymaking by identifying the barriers and facilitators for further development of HTA in Kazakhstan. We reviewed the overall characteristics of the making decisions process in the Healthcare policy. Descriptive and SWOT analyses to identify the potentials and weaknesses were used. The findings were summarized by the authors during their daily work on the implementation of HTA and capacity building, as well as with participation at the international level in forums, including the ISPOR Asia Consortium and ISPOR CEE Network and ISPOR International, in the ISPOR Asia Consortium round table discussions and in the framework of the International Scientific and Practical Conference "Development of Evaluation of Health Technologies in the Eurasian Economic Union” (2017) in Astana, which gave a start to a vector of development of HTA in Kazakhstan and the EEU. We found out that existing HTA model is not complete and concerns only the evaluation of medical equipment, interventions and devices. But the assessment of medicines has not been officially conducted until 2018. There was no official regulation regarding the medicines. There was no of a well-established relationship between HTA, clinical protocols and the national formulary. National mechanism for HTA should serve as a link between research and policymaking. Findings from this study illustrate the possibility of making the HTA process more systematic, transparent and participatory. The next mature step in HTA development should include the national mechanism to ensure sustainable and systematic production of evidence for effective and cost-effective health practices in Kazakhstan.

International Decision Support Initiative (iDSI) Findings on Stakeholder Engagement

An objective of iDSI in its early development was to ‘enhance communication and engagement between key stakeholders, public and private, in the process of HTA development and of priority-setting.’ Meteos was contracted as an iDSI partner to support this objective, specifically with the responsibility to gather stakeholder perspectives, to convene a stakeholder meeting, and to produce a set of recommendations on ongoing mechanisms for stakeholder engagement by iDSI. To meet these objectives, Meteos undertook a stakeholder consultation through interviews with a wide range of stakeholders. This report summarises the outcomes of interviews conducted in May-July 2015. This document covers the two main questions for this exercise: stakeholder perspectives on iDSI’s impact, and views on iDSI’s approach to stakeholder engagement.

PP123 Management of Patients’ Conflicts Of Interest And Of Commitment In Health Technology Assessment

IntroductionHealth technology assessment (HTA) and the development of clinical practice guidelines (CPGs) support important health policy and clinical decisions. Conflicts of interest (COI) and conflicts of commitment (COC) can undermine the credibility and integrity of these processes, that of the actors involved, and, more alarmingly, the health of the population. Thus, management of COI and COC is critical. Although COI among experts participating in HTA and CPG development are increasingly discussed and managed, little is said about COCs and the possible COI and COC associated with patient participation. The aim of our study, which is part of the Institut national d'excellence en santé et services sociaux (INESSS) continuing improvement process for COI and COC management, was to identify best practices in this matter.MethodsWe examined the COI and COC management policies of ten HTA and CPG organizations and performed a review of the relevant academic literature.ResultsThree HTA and CPG organizations had norms regarding the management of patients’ COI and COC, whether they were representatives of patient associations or not. These norms addressed situations such as: when a patient represents a patients’ association; when a patients’ association or an individual patient has important (financial) ties with the pharmaceutical industry; or when an expert or one of his/her family members suffers from the disease related to the HTA or CPG. The declaration of a COI or COC should not necessarily lead to the individual's exclusion from the entire HTA or CPG development process, but it must lead to some evaluation and management. Patients appointed to share their perspectives are not considered to have COI or COC if their mandate is explicit.ConclusionsThe COI and COC of all participants in HTA and CPG development should be managed fairly and transparently. Therefore, the management of COI and COC among patients participating in HTA or CPG development should be based on the same principles as those applied to clinical experts.

OP72 HTA Beyond 2020 In China： HB-HTA Rising Up In Tertiary Hospitals

IntroductionHealth technology assessment (HTA) was introduced into China more than 20 years ago and has developed rapidly recently. While only recently has the concept of hospital-based health technology assessment (HB-HTA) attracted attention in China. The purpose of this study is to investigate the views of government officials, decision makers and relevant stakeholders in the management and application of medical technologies in hospitals, within the environment of Health System Reform in China. We analysed the current situation and identified obstacles and prospects of HB-HTA in Chinese tertiary hospitals.MethodsWe conducted semi-structured interviews in 8 provinces in Eastern, Central and Western China; in 2 to 4 tertiary public hospitals in each province. We interviewed doctors, nurses, and Chiefs in hospitals, and key informants in the National Center for Medical Service Administration.ResultsA total of 98 people participated in the panel discussions and interviews. We found that: 1.China's tertiary public hospitals have embraced HB-HTA, and various hospitals have performed different forms of HB-HTA (including ambassador model, Mini-HTA model, and internal committee model). However, the assessment process, standards, and methods are yet to be standardized.2.The promotion of HB-HTA in China's tertiary public hospitals has remarkable external incentives and internal advantages.3.The lack of HB-HTA professionals, improvements in cognition level, and evidence-based decision-making models and management culture hinders the development of HB-HTA in China.ConclusionsHB-HTA is in high demand in China, especially in tertiary hospitals. It will continue to develop rapidly over the next decade along with the development of China's HTA. HB-HTA will complement the national HTA to jointly extend the Chinese HTA system.

Using HTA and guideline development as a tool for research priority setting the NICE way: reducing research waste by identifying the right research to fund.

BackgroundThe National Institute for Health and Care Excellence (NICE) was established in 1999 and provides national guidance and advice to improve health and social care. Several steps in the research...

DEVELOPMENT OF HEALTH TECHNOLOGY ASSESSMENT IN ROMANIA.

The aim of this study was to describe and analyze the introduction of health technology (HTA) in Romania. Based on a review of the literature and legislative documents and personal experiences and observations, the authors describe, evaluate, and explain the background and evolution of the HTA system. Initiatives to introduce HTA in Romania date from the early 1990s, but real steps were taken only in 2012 when the European Union Directive 2011/24/ on the application of patients' rights in cross-border health care had to be passed into Romanian law. The main developments consist of: the establishment of a national competent authority, the development of a methodology for the rapid assessment of drugs, setting HTA as the main tool for compiling the list of medicines to be covered by the NHIF, and capacity building initiatives. One early result of HTA implementation was an updated list of reimbursed drugs, allowing Romanian patients access to new, innovative medicines. In Romania, HTA become an issue for all stakeholders: decision makers are interested in cost-containment, patients in obtaining the best care, and producers in receiving acceptable reimbursement remains on the health policy agenda. Further steps are envisaged, especially for international collaboration, which is considered an important factor for HTA development in Romania.

PHP127 - Development of Hta In Kazakhstan

PHP127 - Development of Hta In Kazakhstan

Development of Hta in Turkey.

Development of Hta in Turkey.

A MODEL FOR HTA PRIORITY SETTING: EXPERIENCE IN LITHUANIA

To promote the further development of HTA, this study aims to design a model for HTA priority setting, which would address national needs for a country with little experience in the field of HTA, and assess its feasibility for the health system. Literature search and review, as well as qualitative research have been used in the design and testing of the model for HTA priority setting. To test the model and the methodology, a three-round Delphi study was conducted in 2011 in the form of an electronic questionnaire, which was distributed to the panel of eleven national experts. The panel was composed of experts representing various fields of the health care sector: policy-makers, health care service professionals and academics, with diverse professional roles. The designed model consists of four stages: (i) selection of experts for the panel, (ii) indication and selection of health policy topics, (iii) identification of health technologies, and (iv) priority setting. Three rounds of the Delphi study were performed to test the model and reach expert consensus on a list of health technologies for assessment, including pharmaceuticals, vaccines, medical devices, diagnostic methods, public health interventions, organizational systems, etc. Based on the Delphi technique as a method for consensus building, the model for HTA priority setting was developed for Lithuania; however, it could also be used for other countries with little experience in the field of HTA.