HTA in Poland Wojciech Matusewicz Ph D M

HTA in Poland Wojciech Matusewicz, Ph. D. , M. D. – Director Iga Lipska, M. D. – Head of HTA Department Agency for Health Technology Assessment in Poland AHTAPol

1. 2. 3. 4. 5. Poland Polish health care system AHTAPol legal basis AHTAPol tasks and activities AHTAPol analytic team Drug reimbursement / HTA

Poland

Polish health care system • • • Centralised Health insurance system - taxes National Health Fund (NHF) 16 regional branches NHF concludes contracts with health service providers NHF budget for 2009 is 56, 8 billion PLN (14 billion EURO) Drug reimbursement - 7, 3 billion PLN (12, 9%) Therapeutic drug programs - 1, 3 billion PLN (2%) Total public spending about 4% GDP.

AHTAPol - Legal basis • Created in 2005 (Ordinance by Mo. H Sept 2005) • The possible lowest legal act • So far updated every year: ü June 2006 ü Sept 2007 ü Sept 2008 • Steps undertaken to prepare the Law on AHTAPol establishment • The Bill prepared and submitted for Parliament work • Planned to come into force in 2009 (June? )

AHTAPol – tasks and activities • • • Still a lot of discussions Which activities should be performed by this institution Which model of the Agency should be implemented ü Light ü Heavy (limitations) ü Mixed • International collaboration! ü EUnet. HTA, INAHTA, HTAi, ISPOR, GIN • • • Drug reimbursement list (Transparency Directive!) Therapeutic programmes Non – drug technologies

AHTAPol - tasks and activities

AHTAPol – FUTURE tasks and activities • Horizon scanning/new and emerging technologies ü • • • Stakeholders’ involvement Screenning programmes Education in HTA ü • • • Early warning/awarness system Cascading/distance learning programmes Registries Clinical Practise Guidelines Eastern Dimension Capacity Building

AHTAPol - Analytic team • • Build a strong team - one of the biggest tasks for a new institution Motivation system created to maintain people working in Agency ü Continuous trainings ü International collaboration ü Professional development • • • Money, money… Maybe not only : )) Salaries - public administration v. private sector

AHTAPol - Analytic team POSSIBILITIES • • • EU funded project 2 million EURO Twinning project Poland - France (Oct 2006 - Apr 2008) 2 Components: Institutional - proposals of structural and procedural improvements for AHTAPol and other institutions Trainings in EBM and HTA ü ü ü DOERS – about 30 people USERS – about 300 people Training for trainers – about 15 people trainned 7 internships 2 months long CORE of THE TEAM 1 internship 6 months long

AHTAPol - Analytic team

Drug reimbursement / HTA • Drug reimbursement list • Therapeutic programmes • Revision of applications ü Submitted by the industry • Assessment of analysis in terms of credibility and quality ü Clinical effectiveness ü Cost effectiveness ü Budget impact analysis • Consultative Council (CC) – the role

CC recommendation types • • “Finance” “Finance temporarily, provided that the data are gathered to a final decision” ”Finance provided that some precisely criteria are met or in particular indications” “Finance provided that a cost-effective way of financing was assured” “Not to finance” “Increase financing” “Decrease financing” ”Not to change financing”

HTA in decision making process • Assessment and Appraisal • Completely separated processes • Assessment/Revision of industry submission – by Analytic Team • Appraisal – by Consultative Council • CC recommendation • Decision making – Ministry of Health

• Thank you for your attention • Questions? ? ?