Objectives: We describe a new evidence-based method for screening and evaluating emerging medical technologies. Washington State agencies, under legislative direction, have granted authority to its agency Medical Directors and policy leaders to make coverage decisions on medical technologies using a “dossier” process. The dossier process is employed when technology advocates or manufacturers request Washington State healthcare purchasers to pay for new and emerging technologies. This offers the advocate an opportunity to submit scientific evidence and information classically associated with a more formal health technology assessment.

Methods: The submitted information is independently reviewed and summarized for Washington State's public healthcare purchasers allowing a more standardized coverage decision for all public purchasers in Washington State.

Results: This process has allowed Washington State to make twelve evidence-based coverage decisions at a fraction of the cost of classic technology assessment. To date, of twelve reviews over 6 years, one health technology was approved for coverage, ten were not covered and one did not require a coverage decision.

Conclusions: This evidence-based dossier process has yielded high-value coverage decisions of new and emerging medical technologies for public healthcare purchasers in Washington State.

Background: Decision makers in middle-income countries are using economic evaluations (EEs) in pricing and reimbursement decisions for pharmaceuticals. However, whilst many of these jurisdictions have local submission guidelines and local expertise, the studies themselves often use economic models developed elsewhere and elements of data from countries other than the jurisdiction concerned. The objectives of this study were to describe the current situation and to assess the challenges faced by decision makers in transferring data and analyses from other jurisdictions.

Methods: Experienced health service researchers in each region conducted an interview survey of representatives of decision making bodies from jurisdictions in Asia, Central and Eastern Europe, and Latin America that had at least 1 year's experience of using EEs.

Results: Representatives of the relevant organizations in twelve countries were interviewed. All twelve jurisdictions had developed official guidelines for the conduct of EEs. All but one of the organizations evaluated studies submitted to them, but 9 also conducted studies and 7 commissioned them. Nine of the organizations stated that, in evaluating EEs submitted to them, they had consulted a study performed in a different jurisdiction. Data on relevant treatment effect was generally considered more transferable than those on prices/unit costs. Views on the transferability of epidemiological data, data on resource use and health state preference values were more mixed. Eight of the respondents stated that analyses submitted to them had used models developed in other jurisdictions. Four of the organizations had a policy requiring models to be adapted to reflect local circumstances. The main obstacles to transferring EEs were the different patterns of care or wealth of the developed countries from which most economic evaluations originate.

Conclusions: In middle-income countries it is commonplace to deal with the issue of transferring analyses or data from other jurisdictions. Decision makers in these countries face several challenges, mainly due to differences in current standard of care, practice patterns, or gross domestic product between the developed countries where the majority of the studies are conducted and their own jurisdiction

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.