Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T06:49:48.180Z Has data issue: false hasContentIssue false

Health Technology Assessment in Thailand: Institutionalization and Contribution to Healthcare Decision Making: Review of Literature

Published online by Cambridge University Press:  13 June 2019

Pattara Leelahavarong
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Suradech Doungthipsirikul*
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Suthasinee Kumluang
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Akanittha Poonchai
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Nitichen Kittiratchakool
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Danai Chinnacom
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Netnapis Suchonwanich
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
Sripen Tantivess
Affiliation:
Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand
*
Author for correspondence: Suradech Doungthipsirikul, E-mail: suradech.d@hitap.net

Abstract

Objectives

To explore health technology assessment (HTA) in Thailand focusing on its institutionalization, key elements for HTA introduction, and HTA contribution to policy.

Methods

A review of literature covered a wide range of topics, including the institutionalization of HTA, elements of HTA introduction, and the role of HTA in policy decision making in Thai context. Additional information from the authors’ involvement in the policy decision-making process in Thailand was also considered.

Results

HTA institutionalization comprises processes of introducing HTA, including evidence generation and use in policymaking, building capacity of HTA practitioners, organizations, system infrastructure, and collaborations. In Thailand, HTA has been formally integrated into coverage decisions, including in the development of the National List of Essential Medicines and the Universal Health Coverage Scheme benefits package. Contributing factors included political will and leadership, capacity building on HTA-related disciplines, adequate resources, technical expertise, and data. Conversely, challenges faced included the absence of a governing body and strategic plan for HTA systems development, a lack of formal mechanisms for mobilizing financial support, an inadequate number of HTA researchers in nonprofit institutes, and the rise in advanced biotechnologies.

Conclusions

HTA plays an important role in evidence-based healthcare decision making. However, key elements of HTA institutionalization need to be strengthened, especially governance structure and policy for HTA systems development, building and retaining capacity of HTA practitioners to meet demand, addressing the challenges of complex and highly innovative health interventions. Lessons learned from the Thai experience may be used as guidance for HTA institutionalization in other developing countries.

Type
Theme Submission
Copyright
Copyright © Cambridge University Press 2019

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.)

Footnotes

HITAP is funded by the Thailand Research Fund under the senior research scholar on Health Technology Assessment (RTA5980011) and the Bureau of Health Policy and Strategy, Ministry of Public Health. HITAP's international unit has been supported by the international Decision Support Initiative (funded by the Bill & Melinda Gates Foundation and the Department for International Development (DFID), the United Kingdom government department responsible for administering overseas aid to promote sustainable development and eliminate world poverty) and the Rockefeller Foundation to provide technical assistance on health intervention and technology assessment for governments of low- and middle-income countries. The findings, interpretations and conclusions expressed in this article do not necessarily reflect the views of the aforementioned funding agencies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

1.Hanvoravongchai, P (2013) Health Financing Reform in Thailand: Toward Universal Coverage under Fiscal Constraints. UNICO Study Series 20. Washington DC: The World Bank.Google Scholar
2.Vasavid, C, Janyapong, S, Greetong, T, et al. (2015) Thai National Health Accounts 2012. Nonthaburi, Thailand: International Health Policy Program (IHPP) (in Thai).Google Scholar
3.Velasco, M, Perleth, M, Drummond, M, et al. (2002) Best practice in undertaking and reporting health technology assessments. Working group 4 report. Int J Technol Assess Health Care 18, 361422.Google ScholarPubMed
4.Tantivess, S (2008) Policy making and roles of health technology assessment. J Med Assoc Thai 91(Suppl 2), S88S99.Google ScholarPubMed
5.Mohara, A, Youngkong, S, Velasco, RP, et al. (2012) Using health technology assessment for informing coverage decisions in Thailand. J Compar Eff Res 1, 137146.CrossRefGoogle ScholarPubMed
6.Teerawattananon, Y, Tritasavit, N, Suchonwanich, N, Kingkaew, P (2014) The use of economic evaluation for guiding the pharmaceutical reimbursement list in Thailand. Z Evid Fortbild Qual Gesundheitswes 108, 397404.CrossRefGoogle ScholarPubMed
7.Rajan, A, Gutierrez-Ibarluzea, I, Moharra, M (2011) Addressing issues in health technology assessment promotion: motives, enablers, and barriers. Int J Technol Assess Health Care 27, 5563.CrossRefGoogle ScholarPubMed
8.Chootipongchaivat, S, Tritasavit, N, Luz, A, Teerawattananon, Y, Tantivess, S (2015) Factors Conducive to the Development of Health Technology Assessment in Asia: Impacts and Policy Options. Manila: World Health Organization, Regional Office for the Western Pacific.Google Scholar
9.Teerawattananon, Y, Tantivess, S, Yothasamut, J, Kingkaew, P, Chaisiri, K (2009) Historical development of health technology assessment in Thailand. Int J Technol Assess Health Care 25(Suppl 1), 241252.CrossRefGoogle ScholarPubMed
10.Tomson, G, Sundbom, R (1999) The Technology Assessment and Social Security in Thailand (TASSIT) Project Report. Stockholm: Division of International Health (IHCAR), Karolinska Institute.Google Scholar
11.Tantivess, S, Teerawattananon, Y, Mills, A (2009) Strengthening cost-effectiveness analysis in Thailand through the establishment of the health intervention and technology assessment program. PharmacoEconomics 27, 931945.CrossRefGoogle ScholarPubMed
12.Teerawattananon, Y, Tangcharoensathien, V (2004) Designing a reproductive health services package in the universal health insurance scheme in Thailand: match and mismatch of need, demand and supply. Health Policy Plan 19(Suppl 1):i31i39.CrossRefGoogle ScholarPubMed
13.Teerawattananon, Y, Chaikledkaew, U (2008) Thai health technology assessment guideline development. J Med Assoc Thai 91(Suppl 2), S11S15.Google ScholarPubMed
14.Riewpaiboon, A (2014) Standard cost lists for health economic evaluation in Thailand. J Med Assoc Thai 97(Suppl 5) S127S134.Google ScholarPubMed
15.Perez, R, Chaikledkaew, U, Youngkong, S, Tantivess, S, Teerawattananon, Y (2012) Health Technology Assessment Process Guidelines. Nonthaburi, Thailand: Health Intervention and Technology Assessment Program (HITAP).Google Scholar
16.Pattanaphesaj, J, Thavorncharoensap, M (2015) Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in the Thai diabetes patients. Health Qual Life Outcomes 13, 14.CrossRefGoogle ScholarPubMed
17.Chaikledkaew, U, Kittrongsiri, K (2014) Guidelines for health technology assessment in Thailand (second edition)--the development process. J Med Assoc Thai 97(Suppl 5), S4S9.Google ScholarPubMed
18.Department of Medical Services (2016) Department of Medical Services, 2016–2019. (in Thai). Nonthaburi, Thailand: Department of Medical Services.Google Scholar
19.Tantivess, S (2014) Social and ethical analysis in health technology assessment. J Med Assoc Thai 97(Suppl 5), S81S86.Google ScholarPubMed
20.Phoolcharoen, W (2004) Quantum Leap: The Reform of Thailand's Health System. Nonthaburi, Thailand: Health Systems Research Institute.Google Scholar
21.Swanson, R, Cattaneo, A, Bradley, E, et al. (2012) Rethinking health systems strengthening: key systems thinking tools and strategies for transformational change. Health Policy Plan 27, v54v61.CrossRefGoogle ScholarPubMed
22.Rasanathan, K, Posayanonda, T, Birmingham, M, Tangcharoensathien, V (2011) Innovation and participation for healthy public policy: the first National Health Assembly in Thailand. Health Expect 15, 8796.CrossRefGoogle ScholarPubMed
23.Slutsky, J, Tumilty, E, Max, C, et al. (2016) Patterns of public participation: opportunity structures and mobilization from a cross-national perspective. J Health Organ Manag 30, 751768.CrossRefGoogle Scholar
24.World Health Organization (2015) Global Survey on Health Technology Assessment by National Authorities. Main findings. Geneva: WHO.Google Scholar
25.Velasco, RP, Chaikledkaew, U, Myint, C, Khampang, R, Tantivess, S, Teerawattananon, Y (2013) Advanced health biotechnologies in Thailand: redefining policy directions. J Transl Med 11, 1.CrossRefGoogle ScholarPubMed
Supplementary material: File

Leelahavarong et al. supplementary material

Tables S1 and S2

Download Leelahavarong et al. supplementary material(File)
File 32.6 KB