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Kc S, Lin LW, Bayani DBS, Zemlyanska Y, Adler A, Ahn J, Chan K, Choiphel D, Genuino-Marfori AJ, Kearney B, Liu Y, Nakamura R, Pearce F, Prinja S, Pwu RF, Akmal Shafie A, Sui B, Suwantika A, Tunis S, Wu HM, Zalcberg J, Zhao K, Isaranuwatchai W, Teerawattananon Y, Wee HL. What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection Into the Past and A Way Forward. Int J Health Policy Manag 2023; 12:6858. [PMID: 37579427 PMCID: PMC10461954 DOI: 10.34172/ijhpm.2023.6858] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/28/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Globally, there is increasing interest in the use of real-world data (RWD) and real-world evidence (RWE) to inform health technology assessment (HTA) and reimbursement decision-making. Using current practices and case studies shared by eleven health systems in Asia, a non-binding guidance that seeks to align practices for generating and using RWD/RWE for decision-making in Asia was developed by the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) Working Group, addressing a current gap and needs among HTA users and generators. METHODS The guidance document was developed over two face-to-face workshops, in addition to an online survey, a face-to-face interview and pragmatic search of literature. The specific focus was on what, where and how to collect RWD/ RWE. RESULTS All 11 REALISE member jurisdictions participated in the online survey and the first in-person workshop, 10 participated in the second in-person workshop, and 8 participated in the in-depth face-to-face interviews. The guidance document was iteratively reviewed by all working group members and the International Advisory Panel. There was substantial variation in: (a) sources and types of RWD being used in HTA, and (b) the relative importance and prioritization of RWE being used for policy-making. A list of national-level databases and other sources of RWD available in each country was compiled. A list of useful guidance on data collection, quality assurance and study design were also compiled. CONCLUSION The REALISE guidance document serves to align the collection of better quality RWD and generation of reliable RWE to ultimately inform HTA in Asia.
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Affiliation(s)
- Sarin Kc
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand
| | - Lydia Wenxin Lin
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore
| | | | - Yaroslava Zemlyanska
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore
| | - Amanda Adler
- The Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, UK
| | | | - Kelvin Chan
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada
| | - Dechen Choiphel
- Essential Medicine and Technology Division, Department of Medical Services, Ministry of Health, Thimphu, Bhutan
| | | | - Brendon Kearney
- Faculty of Medicine, University of Adelaide, Adelaide, SA, Australia
- Health Policy Advisory Committee on Technology, Brisbane, QLD, Australia
| | - Yuehua Liu
- China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Fiona Pearce
- Agency for Care Effectiveness, Ministry of Health, Singapore, Singapore
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Raoh-Fang Pwu
- Taiwan National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan
| | - Arsul Akmal Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Binyan Sui
- China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China
| | - Auliya Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Sean Tunis
- Center for Medical Technology Policy (CMTP), Baltimore, MD, USA
| | - Hui-Min Wu
- Taiwan National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan
| | - John Zalcberg
- Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Medical Oncology, Alfred Hospital, Melbourne, VIC, Australia
| | - Kun Zhao
- China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand
- Centre for Excellence in Economic Analysis Research, St. Michael’s Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore
| | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore (NUS), Singapore, Singapore
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Pempa, Luz ACG, Luangasanatip N, Kingkaew P, Adhikari D, Isaranuwatchai W, Choiphel D, Pecenka C, Debellut F. Economic evaluation of rotavirus vaccination in children of Bhutan. Vaccine 2020; 38:5049-5059. [PMID: 32522415 PMCID: PMC7327517 DOI: 10.1016/j.vaccine.2020.05.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/03/2020] [Accepted: 05/13/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Diarrhoea remains one of the top ten causes of under-five child morbidity in Bhutan, and rotavirus is a significant cause of child diarrhoeal hospitalisations. This study sought to determine the health outcomes, cost-effectiveness, and budget and human resource implications of introducing rotavirus vaccines in the routine immunisation program to inform Bhutan's decision-making process. METHODS We used UNIVAC model (version 1.3.41) to evaluate the cost-effectiveness of a rotavirus vaccination programme compared with no vaccination from a government perspective. We also projected the impact of rotavirus vaccination on human resources and budget. Acost-effectiveness threshold was determined to be 0.5 times the gross domestic product (GDP) per capita (equivalent to the United States dollar ($) 1,537) per Disability-Adjusted Life-Year (DALY) averted.One-way deterministic and probabilistic sensitivity analyses, and threshold analyses were performed to capture parameter uncertainties. RESULTS In Bhutan, a rotavirus vaccination programme over 10 years (2020 to 2029) can avert between 104 and 115 DALYs, at an incremental cost ranging from $322,000 to $1,332,000. The incremental cost-effectiveness ratio (ICER) across four vaccination programmes compared to no vaccination scenario were $9,267, $11,606, $3,201, and $2,803 per DALY averted for ROTARIX, RotaTeq, ROTAVAC, and ROTASIIL, respectively. The net five-year budget impact of introducing a rotavirus vaccination programme ranged from $0.20 to $0.81 million. The rotavirus vaccination programme has a potential to reduce the workload of health care workers such as paediatricians, nurses, dieticians, and pharmacists; however, the programme would require an additional 1.93-2.88 full-time equivalent of health assistants. CONCLUSION At the current cost-effectiveness threshold, routine rotavirus vaccination in Bhutan is unlikely to be cost-effective with any of the currently available vaccines. However, routine vaccination with ROTASIIL was under the cost-effectiveness threshold of one times the GDP per capita ($3,074). ROTASIIL and ROTAVAC would provide the best value for money in Bhutan.
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Affiliation(s)
- Pempa
- Essential Medicines and Technology Division, Department of Medical Services, Ministry of Health, Bhutan
| | - Alia Cynthia G Luz
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health (MoPH), Thailand
| | - Nantasit Luangasanatip
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Pritaporn Kingkaew
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health (MoPH), Thailand.
| | - Deepika Adhikari
- Essential Medicines and Technology Division, Department of Medical Services, Ministry of Health, Bhutan
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health (MoPH), Thailand; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| | - Dechen Choiphel
- Essential Medicines and Technology Division, Department of Medical Services, Ministry of Health, Bhutan
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