Abstract
Following the last series of article, the use of Health Technology Assessment (HTA) in Europe was introduced in this article.
In the UK, National Institute for the Health and Clinical Excellence, called NICE, founded in 1999, has been taken the role of providing recommendations of standardised use of what health technologies including drugs should be provided to the National Health Service, based on the of clinical and cost-effectiveness evidence.
While NICE’s decision brings the wider use of health technologies recommended in its guidance, those of which has not recommended were less prescribed by physician, and as a result, it lead a limited access to those technologies. In order to resolve the issues of limited access to technologies, UK government has begun to take supplementary measures so that some of the pharmaceuticals to which NICE has limited the access could be used under NHS.
In Germany, in order to evaluate the quality and efficiency of health care, the Institute for Quality and Efficiency in Health Care, IQWiG was established in 2004. While a unique concept called the Efficient Frontier has been proposed in the draft guidelines afterwards, since the new Act called AMNOG was enacted in 2011, the role of IQWiG has been changed from the one initially expected.
In France, Haute Autorité de santé (HAS) was founded since 2005. So far, economic evaluation on new drugs has not been used to their pricing. However, the draft economic evaluation guidelines was published in 2010 and it is becoming active in its policy use.
In summary, we found that the difference of the way of applying economic valuation into policies and the use of each element, such as QALY, threshold, discount rate, perspectives, between 5 countries. To implement HTA to Japanese healthcare policy, these differences and the technical issues has to be fully taken into account, and require a sensitive handling.
