Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T16:25:13.988Z Has data issue: false hasContentIssue false

Towards greater impact in health technology assessment: horizon scanning for new and emerging technologies in Singapore

Published online by Cambridge University Press:  22 June 2020

Wan Qing Wong
Affiliation:
Agency for Care Effectiveness, Ministry of Health, Singapore, College of Medicine Building, 16 College Road, Singapore169854, Singapore
Liang Lin
Affiliation:
Agency for Care Effectiveness, Ministry of Health, Singapore, College of Medicine Building, 16 College Road, Singapore169854, Singapore
Hong Ju
Affiliation:
Agency for Care Effectiveness, Ministry of Health, Singapore, College of Medicine Building, 16 College Road, Singapore169854, Singapore
Kwong Ng*
Affiliation:
Agency for Care Effectiveness, Ministry of Health, Singapore, College of Medicine Building, 16 College Road, Singapore169854, Singapore
*
Author for correspondence: Kwong Ng, E-mail: ng_kwong_hoe@moh.gov.sg

Abstract

Objectives

To alert policy makers early about emerging health technologies that could significantly impact the healthcare system at the clinical, financial and organizational levels, the Agency for Care Effectiveness (ACE) in Singapore established a horizon scanning system (HSS) in 2019. This paper describes the development of the ACE HSS and showcases its application with cell and gene therapy products as the first example.

Methods

A literature review of existing HSS methods, including the processes of the EuroScan International Network and other overseas horizon scanning agencies, was done to inform the development of our horizon scanning framework. The framework was first applied to the new and emerging cell and gene therapies.

Results

Identification sources, filtration and prioritization criteria, and horizon scanning outputs for the HSS were developed in alignment to international best practices, with recommendations for technology uptake represented by a traffic light system. For the first horizon scanning exercise on cell and gene therapies, forty therapies passed the filtration step, of which eight were prioritized for further assessment. The few early reports developed were used to inform and prepare the healthcare system for their potential introduction, particularly in terms of the need to develop health and funding policies.

Conclusions

Early assessment of prioritized topics has provided support for strategic efforts within the Ministry of Health. Given that ACE's horizon scanning program is still in its infancy, the framework will continue to evolve to ensure relevance to our stakeholders so that it remains fit for purpose for our healthcare system.

Type
Method
Copyright
Copyright © Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Pearce, F, Lin, L, Teo, E, Ng, K, Khoo, D. HTA and its use in drug policies: Singapore. Value Health Reg Issues. 2019;18:176–83.CrossRefGoogle ScholarPubMed
EuroScan International Network. A toolkit for the identification and assessment of new and emerging health technologies. Birmingham: EuroScan International Network; 2014.Google Scholar
Oortwijn, W. Facing the dynamics of future innovation: The role of HTA, industry and health system in scanning the horizon. HTAi Global Policy Forum 2018 Background Paper; 2018.Google Scholar
Packer, C, Simpson, S, de Almeida, RT. Euroscan International Network Member Agencies: Their structure, processes, and outputs. Int J Technol Assess Health Care. 2015;31:7885.CrossRefGoogle ScholarPubMed
Lepage-Nefkens, I, Douw, K, Mantjes, G, de Graaf, G, Leroy, R, Cleemput, I. Horizon scanning for pharmaceuticals. Proposal for the BeNeLuxA collaboration. Health Services Research (HSR) Brussels: Belgian Health Care Knowledge Centre (KCE). KCE Reports 283; 2017.Google Scholar
Minister Bruins: start of a new international partnership of medicines [press release]. Government of the Netherlands, 29 October 2019. Available from: https://www.government.nl/.Google Scholar
Eriksson, I, Wettermark, B, Persson, M, Edström, M, Godman, B, Lindhé, A. The early awareness and alert system in Sweden: History and current status. Front Pharmacol. 2017;8:674.CrossRefGoogle ScholarPubMed
Hines, P, Li, HY, Guy, RH, Brand, A, Papaluca-Amati, M. Scanning the horizon: A systematic literature review of methodologies. BMJ Open. 2019;9:e026764.CrossRefGoogle ScholarPubMed
Gutierrez-Ibarluzea, I, Simpson, S, Benguria-Arrate, G. Early awareness and alert systems: An overview of EuroScan methods. Int J Technol Assess Health Care. 2012;28:301–07.CrossRefGoogle ScholarPubMed
Elverum, K, Whitman, M. Delivering cellular and gene therapies to patients: Solutions for realizing the potential of the next generation of medicine. Gene Ther. 2019. https://doi.org/10.1038/s41434-019-0074-7CrossRefGoogle ScholarPubMed
Gelijns, AC, Institute of Medicine (US) Committee on Technological Innovation in Medicine. Technological innovation: Comparing development of drugs, devices, and procedures in medicine. Washington, DC: National Academies Press (US); 1989. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222710/.Google ScholarPubMed
Van Norman, GA. Drugs, devices, and the FDA: Part 2: An overview of approval processes: FDA approval of medical devices. JACC Basic Transl Sci. 2016;1(4):277–87.CrossRefGoogle ScholarPubMed
Van Norman, GA. Drugs, devices, and the FDA: Part 1: An overview of approval processes for drugs. JACC Basic Transl Sci. 2016;1(3):170–79.CrossRefGoogle Scholar
Sun, F, Schoelles, K. A systematic review of methods for health care technology horizon scanning. Rockville, MD: Agency for Healthcare Research and Quality; 2013. Available from: https://effectivehealthcare.ahrq.gov/.Google Scholar
Douw, K, Vondeling, H. Selection of new health technologies for assessment aimed at informing decision making: A survey among horizon scanning systems. Int J Technol Assess Health Care. 2006;22:177–83.Google ScholarPubMed
Maude, SL, Laetsch, TW, Buechner, J, Rives, S, Boyer, M, Bittencourt, H et al. Tisagenlecleucel in children and young adults with B-cell lymphoblastic leukemia. N Engl J Med. 2018;378:439–48.CrossRefGoogle Scholar
Bach, PB, Giralt, SA, Saltz, LB. FDA approval of tisagenlecleucel: Promise and complexities of a $475000 cancer drug. JAMA. 2017;318:1861–62.CrossRefGoogle ScholarPubMed
Cuende, N, Rasko, JEJ, Koh, MBC, Dominici, M, Ikonomou, L. Cell, tissue and gene products with marketing authorization in 2018 worldwide. Cytotherapy. 2018;20:1401–13.CrossRefGoogle ScholarPubMed
Gene therapy's next installment. Nat Biotechnol. 2019, https://doi.org/10.1038/s41587-019-0194-z.Google Scholar
Statement from FDA Commissioner Scott Gottlieb, M.D. and Peter Marks, M.D., Ph.D., Director of the Center for Biologics Evaluation and Research on new policies to advance development of safe and effective cell and gene therapies [press release]. Food and Drug Administration, January 15 2019. Available from: https://www.fda.gov/.Google Scholar
Wild, C, Langer, T. Emerging health technologies: Informing and supporting health policy early. Health Policy. 2008;87:160–71.CrossRefGoogle ScholarPubMed
Iglesias-López, C, Agustí, A, Obach, M, Vallano, A. Regulatory framework for advanced therapy medicinal products in Europe and United States. Front Pharmacol. 2019;10:921.CrossRefGoogle ScholarPubMed
Varela-Lema, L, De La Fuente-Cid, R, Lopez-Garcia, M. Developing a prioritized list of innovative technologies: The Spanish experience. Int J Technol Assess Health Care. 2014;30:626–33.Google ScholarPubMed
Agency for Care Effectiveness—Our Guidance. Singapore: Ministry of Health; 2017. Available from: https://www.ace-hta.gov.sg/our-guidance.Google Scholar