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Improving Access to High-Cost Technologies in the Asia Region

Part of: Special Collection - Policy Forums

Published online by Cambridge University Press:  24 May 2019

Linda Mundy Open the ORCID record for Linda Mundy [Opens in a new window] ,
Rebecca Trowman  and
Brendon Kearney
Linda Mundy*
Affiliation:
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Health and Medical Sciences Building, Adelaide, South Australia
Rebecca Trowman
Affiliation:
Scientific and Health Policy Initiatives, Edmonton, Alberta, Canada
Brendon Kearney
Affiliation:
HTAi Asia Policy Forum, Department of Haematology, Royal Adelaide Hospital, South Australia
*
Author for correspondence: Linda Mundy, E-mail: [email protected]
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Abstract

Objectives

Discussions at the Health Technology Assessment International (HTAi) Asia Policy Forum (HAPF) aimed to understand the meaning of “high-cost technologies,” and to explore mechanisms to increase access to these technologies in publicly funded health systems in the Asia region.

Methods

Discussions and presentations at the 2018 HAPF, informed by a literature review and a premeeting survey of HTA agencies and industry, form the basis of this paper.

Results

Challenges payers in the public health system face when investing in high-cost technologies include a lack of data, especially real-world data, affordability, and the budgetary impact of high-cost technologies. Managed entry schemes (MES) are one means to enable earlier access to high-cost technologies, or at reduced cost to the system. Most countries surveyed had used an MES to introduce a new health technology and most industry representatives had experience with financial-based MES, such as discounts or rebates, with most put in place to increase access to pharmaceuticals. Little experience of outcome-based or evidence-generation MES was reported.

Conclusions

Although it is early days in the implementation of MES in Asia, they have the potential to play an important role enabling access to new, mainly pharmaceutical, health technologies. The development of a “road map” of MES in the region should outline the intent and need for a MES, articulating the “rules of engagement” for all stakeholders—patients, providers, payers, and industry—which will assist countries to clearly identify the problem trying to be solved, and how an MES can be part of the solution.

Keywords

Technology assessment, healthDecision makingHealth policyReimbursement mechanismsRisk sharingCoverage with evidence development
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 3 , 2019 , pp. 168 - 175
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

The authors thank the members of the HTAi Asia Policy Forum and, in particular, the members of the Policy Forum Organizing Committee and invited speakers who attended the 2018 meeting. This article is based on discussions at the HTAi 2018 Asia Policy Forum held October 29 to 30 in Jakarta, Indonesia.

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