Deliberative processes for health technology assessment: interpretation of the guideline from the Joint HTAi/ISPOR Task Force_Chinese Journal of Evidence-Based Medicine

Authors：

WU Xue ¹ , ZHANG Le ¹ , JING Chengyang ¹ ,  GUO Wudong ² ,  LIAO Xing ¹

1. Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, P. R. China;
2. China National Health Development Research Center, National Health Commission, Beijing 100044, P. R. China;

Corresponding author：

GUO Wudong, Email: guowudong@hotmail.com; LIAO Xing, Email: okfrom2008@hotmail.com

Keywords：

Health technology assessment; Deliberative processes; Guideline; Checklist; Designing and implementing; Quality of decision making

DOI：

10.7507/1672-2531.202308128

Video：

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Health Technology Assessment International (HTAi), in conjunction with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), initiated a joint Task Force and published guideline and a checklist for deliberative processes for health technology assessment (HTA). Currently, there is a lack of guidance for designing and implementing deliberative processes of HTA in China, so this paper performs a detailed interpretation of the guideline and checklist, with a view to providing a reference for China's HTA and deliberative process, in order to promote the dissemination and application of the HTA methodology, and advance the construction of domestic HTA deliberative processes capacity and institutional mechanism.

Citation： WU Xue, ZHANG Le, JING Chengyang, GUO Wudong, LIAO Xing. Deliberative processes for health technology assessment: interpretation of the guideline from the Joint HTAi/ISPOR Task Force. Chinese Journal of Evidence-Based Medicine, 2024, 24(2): 211-219. doi: 10.7507/1672-2531.202308128 Copy

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2.	Gauvin FP. What is a deliberative process? The National Collaborating Centre for Healthy Public Policy, 2009.
3.	Bond K, Stiffell R, Ollendorf DA. Principles for deliberative processes in health technology assessment. Int J Technol Assess Health Care, 2020, 36(4): 445-452.
4.	Dobrow MJ, Culyer T, Lemieux-Charles L, et al. Designing deliberative methods for combining heterogeneous evidence: a systematic review and qualitative scan. Ottawa: Canadian Health Services Research Foundation, 2009.
5.	Abelson J, Forest PG, Eyles J, et al. Deliberations about deliberative methods: issues in the design and evaluation of public participation processes. Soc Sci Med, 2003, 57(2): 239-251.
6.	Jonathan L, Tony C, Chris M, et al. Conceptualizing and combining evidence for health system guidance. Ottawa: Canadian Health Services Research Foundation, 2005.
7.	Oortwijn W, Jansen M, Baltussen R. Evidence-informed deliberative processes. A practical guide for HTA bodies for legitimate benefit package design (2nd edition). Nijmegen: Radboud University Medical Center, 2021.
8.	Oortwijn W, Husereau D, Abelson J, et al. Designing and implementing deliberative processes for health technology assessment: a good practices report of a joint HTAi/ISPOR Task Force. Value Health, 2022, 25(6): 869-886.
9.	Malone DC, Ramsey SD, Patrick DL, et al. Criteria and process for initiating and developing an ISPOR Good Practices Task Force report. Value Health, 2020, 23(4): 409-415.
10.	Organisation for Economic Cooperation and Development (OECD). Innovative citizen participation and new democratic institutions catching the deliberative wave. Paris: OECD Publishing, 2020.
11.	Boothe K. "Getting to the Table": changing ideas about public and patient involvement in Canadian drug assessment. J Health Polit Policy Law, 2019, 44(4): 631-663.
12.	Solomon S, Abelson J. Why and when should we use public deliberation. Hastings Cent Rep, 2012, 42(2): 17-20.
13.	Yesilkagit K, Christensen JG. Institutional design and formal autonomy: political versus historical and cultural explanations. J Public Adm Res Theory, 2009, 20(1): 53-74.
14.	Landwehr C, Böhm K. Delegation and institutional design in health-care rationing. Governance, 2011, 24: 665-688.
15.	Abelson J, Wagner F, DeJean D, et al. Public and patient involvement in health technology assessment: a framework foraction. Int J Technol Assess Health Care, 2016, 32(4): 256-264.
16.	Glassman A, Chalkidou K, Giedion U, et al. Priority-setting institutions in health: recommendations from a center for global development working group. Glob Heart, 2012, 7(1): 13-34.
17.	Culyer AJ. Deliberative processes in decisions about health care technologies: combining different types of evidence, values, algorithms and people. Office of Health Economics, 2009.
18.	Pichon-Riviere A, Augustovski F, García Martí S, et al. The link between health technology assessment and decision making for the allocation of health resources in Latin America. Int J Technol Assess Health Care, 2020, 36(2): 173-178.
19.	Kapiriri L, Baltussen R, Oortwijn W. Implementing evidence-informed deliberative processes in health technology assessment: a low income country perspective. Int J Technol Assess Health Care, 2020, 36(1): 29-33.
20.	Pichon-Riviere A, Soto N, Augustovski F, et al. Stakeholder involvement in the health technology assessment process in Latin America. Int J Technol Assess Health Care, 2018, 34(3): 248-253.
21.	Mohara A, Youngkong S, Velasco RP, et al. Using health technology assessment for informing coverage decisions in Thailand. J Comp Eff Res, 2012, 1(2): 137-146.
22.	Vanstone M, Abelson J, Bidonde J, et al. Ethical challenges related to patient involvement in health technology assessment. Int J Technol Assess Health Care, 2019, 35(4): 253-256.
23.	Pichon-Riviere A, Soto NC, Augustovski FA, et al. Health technology assessment for decision making in latin america: good practice principles. Int J Technol Assess Health Care, 2018, 34(3): 241-247.
24.	Kleinhout-Vliek T, de Bont A, Boysen M, et al. Around the tables - contextual factors in healthcare coverage decisions across western Europe. Int J Health Policy Manag, 2020, 9(9): 390-402.
25.	Boers M. Governance of European cooperation processes in health technology assessment. Rotterdam: Erasmus University, 2020.
26.	Have AT, Oortwijn W, Broos P, et al. European cooperation on health technology assessment: economic and governance analysis of the establishment of a permanent secretariat. 2013.
27.	European Network for Health Technology Assessment (EUnetHTA). An analysis of HTA and reimbursement procedures in EUnetHTA partner countries: final report. 2017.
28.	Moynihan R, Oxman AD, Lavis J, et al. A review of organizations that support the use of research evidence in developing guidelines, technology assessments, and health policy, for the WHO Advisory Committee on Health Research. Oslo: Norwegian Knowledge Centre for the Health Services, 2006.
29.	Rothwell JD. In mixed company: communicating in small groups and teams (8th edition). Boston: Harcourt College Publishers, 2013.
30.	Wranik WD, Zielińska DA, Gambold L, et al. Threats to the value of Health Technology Assessment: qualitative evidence from Canada and Poland. Health Policy, 2019, 123(2): 191-202.
31.	Fox J, Shotts KW. Delegates or trustees. A theory of political accountability. J Polit, 2009, 4(71): 1225-1237.
32.	Wortley S, Tong A, Howard K. Community views and perspectives on public engagement in health technology assessment decision making. Aust Health Rev, 2017, 41(1): 68-74.
33.	Werkö SS, Staniszewska S. Patient and public involvement in health technology assessment: a new dawn. Int J Technol Assess Health Care, 2021, 37(1): e54.
34.	Bidonde J, Vanstone M, Schwartz L, et al. An institutional ethnographic analysis of public and patient engagement activities at a national health technology assessment agency. Int J Technol Assess Health Care, 2021, 37: e37.
35.	Bombard Y, Abelson J, Simeonov D, et al. Eliciting ethical and social values in health technology assessment: a participatory approach. Soc Sci Med, 2011, 73(1): 135-144.
36.	Boivin A, Lehoux P, Burgers J, et al. What are the key ingredients for effective public involvement in health care improvement and policy decisions. A randomized trial process evaluation. Milbank Q, 2014, 92(2): 319-350.
37.	Chwalisz C. Good practice principles for deliberative processes for public decision making. In: innovative citizen participation and new democratic institutions. Paris: OECD Publishing, 2020.
38.	Mendonça RF, Ercan SA, Asenbaum H. More than words: a multidimensional approach to deliberative democracy. Polit Stud, 2020, 70(1): 153-172.
39.	Peel A, Jenks M, Choudhury M, et al. Use of expert judgement across NICE guidance-making programmes: a review of current processes and suitability of existing tools to support the use of expert elicitation. Appl Health Econ Health Policy, 2018, 16(6): 819-836.
40.	Janis IL. Groupthink: psychological studies of policy decisions and fiascoes (2nd edition). Boston: Houghton Mifflin, 1982.
41.	Shayo EH, Norheim OF, Mboera LE, et al. Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania. Int J Equity Health, 2012, 11: 30.
42.	Gibson JL, Martin DK, Singer PA. Priority setting in hospitals: fairness, inclusiveness, and the problem of institutional power differences. Soc Sci Med, 2005, 61(11): 2355-2362.
43.	Kao AB, Berdahl AM, Hartnett AT, et al. Counteracting estimation bias and social influence to improve the wisdom of crowds. J R Soc Interface, 2018, 15(141): 20180130.
44.	Kahan JP, Morton SC, Farris HH, et al. Panel processes for revising relative values of physician work. A pilot study. Med Care, 1994, 32(11): 1069-1085.
45.	Simera I, Moher D, Hoey J, et al. The EQUATOR Network and reporting guidelines: helping to achieve high standards in reporting health research studies. Maturitas, 2009, 63(1): 4-6.
46.	Jansen MPM, Baltussen R, Bærøe K. Stakeholder participation for legitimate priority setting: a checklist. Int J Health Policy Manag, 2018, 7(11): 973-976.
47.	Bae EY, Hong JM, Kwon HY, et al. Eight-year experience of using HTA in drug reimbursement: South Korea. Health Policy, 2016, 120(6): 612-620.
48.	National Institute for Health and Care Excellence (NICE). Guide to the technology appraisal and highly specialised technologies appeal process. 2023.
49.	Sibbald SL, Singer PA, Upshur R, et al. Priority setting: what constitutes success. A conceptual framework for successful priority setting. BMC Health Serv Res, 2009, 9: 43.
50.	Mercer RE, Chambers A, Mai H, et al. Are we making a difference? A qualitative study of patient engagement at the pan-canadian oncology drug review: perspectives of patient groups. Value Health, 2020, 23(9): 1157-1162.
51.	Oortwijn W, Determann D, Schiffers K, et al. Towards integrated health technology assessment for improving decision making in selected countries. Value Health, 2017, 20(8): 1121-1130.
52.	Pinilla-Dominguez P, Pinilla-Dominguez J. Deliberative processes in health technology assessment of medicines: the case of Spain. Int J Technol Assess Health Care, 2023, 39(1): e50.
53.	Chen Y, Zhao K, Liu G, et al. Health technology assessment to inform decision making in China: progress, challenges, and sustainability. BMJ, 2023, 381: e068910.

1. Kolotourou K, Ermacora P, Grosvenor A. The evolution of European HTA and access to innovative medicines. J Comp Eff Res, 2019, 8(5): 275-278.
2. Gauvin FP. What is a deliberative process? The National Collaborating Centre for Healthy Public Policy, 2009.
3. Bond K, Stiffell R, Ollendorf DA. Principles for deliberative processes in health technology assessment. Int J Technol Assess Health Care, 2020, 36(4): 445-452.
4. Dobrow MJ, Culyer T, Lemieux-Charles L, et al. Designing deliberative methods for combining heterogeneous evidence: a systematic review and qualitative scan. Ottawa: Canadian Health Services Research Foundation, 2009.
5. Abelson J, Forest PG, Eyles J, et al. Deliberations about deliberative methods: issues in the design and evaluation of public participation processes. Soc Sci Med, 2003, 57(2): 239-251.
6. Jonathan L, Tony C, Chris M, et al. Conceptualizing and combining evidence for health system guidance. Ottawa: Canadian Health Services Research Foundation, 2005.
7. Oortwijn W, Jansen M, Baltussen R. Evidence-informed deliberative processes. A practical guide for HTA bodies for legitimate benefit package design (2nd edition). Nijmegen: Radboud University Medical Center, 2021.
8. Oortwijn W, Husereau D, Abelson J, et al. Designing and implementing deliberative processes for health technology assessment: a good practices report of a joint HTAi/ISPOR Task Force. Value Health, 2022, 25(6): 869-886.
9. Malone DC, Ramsey SD, Patrick DL, et al. Criteria and process for initiating and developing an ISPOR Good Practices Task Force report. Value Health, 2020, 23(4): 409-415.
10. Organisation for Economic Cooperation and Development (OECD). Innovative citizen participation and new democratic institutions catching the deliberative wave. Paris: OECD Publishing, 2020.
11. Boothe K. "Getting to the Table": changing ideas about public and patient involvement in Canadian drug assessment. J Health Polit Policy Law, 2019, 44(4): 631-663.
12. Solomon S, Abelson J. Why and when should we use public deliberation. Hastings Cent Rep, 2012, 42(2): 17-20.
13. Yesilkagit K, Christensen JG. Institutional design and formal autonomy: political versus historical and cultural explanations. J Public Adm Res Theory, 2009, 20(1): 53-74.
14. Landwehr C, Böhm K. Delegation and institutional design in health-care rationing. Governance, 2011, 24: 665-688.
15. Abelson J, Wagner F, DeJean D, et al. Public and patient involvement in health technology assessment: a framework foraction. Int J Technol Assess Health Care, 2016, 32(4): 256-264.
16. Glassman A, Chalkidou K, Giedion U, et al. Priority-setting institutions in health: recommendations from a center for global development working group. Glob Heart, 2012, 7(1): 13-34.
17. Culyer AJ. Deliberative processes in decisions about health care technologies: combining different types of evidence, values, algorithms and people. Office of Health Economics, 2009.
18. Pichon-Riviere A, Augustovski F, García Martí S, et al. The link between health technology assessment and decision making for the allocation of health resources in Latin America. Int J Technol Assess Health Care, 2020, 36(2): 173-178.
19. Kapiriri L, Baltussen R, Oortwijn W. Implementing evidence-informed deliberative processes in health technology assessment: a low income country perspective. Int J Technol Assess Health Care, 2020, 36(1): 29-33.
20. Pichon-Riviere A, Soto N, Augustovski F, et al. Stakeholder involvement in the health technology assessment process in Latin America. Int J Technol Assess Health Care, 2018, 34(3): 248-253.
21. Mohara A, Youngkong S, Velasco RP, et al. Using health technology assessment for informing coverage decisions in Thailand. J Comp Eff Res, 2012, 1(2): 137-146.
22. Vanstone M, Abelson J, Bidonde J, et al. Ethical challenges related to patient involvement in health technology assessment. Int J Technol Assess Health Care, 2019, 35(4): 253-256.
23. Pichon-Riviere A, Soto NC, Augustovski FA, et al. Health technology assessment for decision making in latin america: good practice principles. Int J Technol Assess Health Care, 2018, 34(3): 241-247.
24. Kleinhout-Vliek T, de Bont A, Boysen M, et al. Around the tables - contextual factors in healthcare coverage decisions across western Europe. Int J Health Policy Manag, 2020, 9(9): 390-402.
25. Boers M. Governance of European cooperation processes in health technology assessment. Rotterdam: Erasmus University, 2020.
26. Have AT, Oortwijn W, Broos P, et al. European cooperation on health technology assessment: economic and governance analysis of the establishment of a permanent secretariat. 2013.
27. European Network for Health Technology Assessment (EUnetHTA). An analysis of HTA and reimbursement procedures in EUnetHTA partner countries: final report. 2017.
28. Moynihan R, Oxman AD, Lavis J, et al. A review of organizations that support the use of research evidence in developing guidelines, technology assessments, and health policy, for the WHO Advisory Committee on Health Research. Oslo: Norwegian Knowledge Centre for the Health Services, 2006.
29. Rothwell JD. In mixed company: communicating in small groups and teams (8th edition). Boston: Harcourt College Publishers, 2013.
30. Wranik WD, Zielińska DA, Gambold L, et al. Threats to the value of Health Technology Assessment: qualitative evidence from Canada and Poland. Health Policy, 2019, 123(2): 191-202.
31. Fox J, Shotts KW. Delegates or trustees. A theory of political accountability. J Polit, 2009, 4(71): 1225-1237.
32. Wortley S, Tong A, Howard K. Community views and perspectives on public engagement in health technology assessment decision making. Aust Health Rev, 2017, 41(1): 68-74.
33. Werkö SS, Staniszewska S. Patient and public involvement in health technology assessment: a new dawn. Int J Technol Assess Health Care, 2021, 37(1): e54.
34. Bidonde J, Vanstone M, Schwartz L, et al. An institutional ethnographic analysis of public and patient engagement activities at a national health technology assessment agency. Int J Technol Assess Health Care, 2021, 37: e37.
35. Bombard Y, Abelson J, Simeonov D, et al. Eliciting ethical and social values in health technology assessment: a participatory approach. Soc Sci Med, 2011, 73(1): 135-144.
36. Boivin A, Lehoux P, Burgers J, et al. What are the key ingredients for effective public involvement in health care improvement and policy decisions. A randomized trial process evaluation. Milbank Q, 2014, 92(2): 319-350.
37. Chwalisz C. Good practice principles for deliberative processes for public decision making. In: innovative citizen participation and new democratic institutions. Paris: OECD Publishing, 2020.
38. Mendonça RF, Ercan SA, Asenbaum H. More than words: a multidimensional approach to deliberative democracy. Polit Stud, 2020, 70(1): 153-172.
39. Peel A, Jenks M, Choudhury M, et al. Use of expert judgement across NICE guidance-making programmes: a review of current processes and suitability of existing tools to support the use of expert elicitation. Appl Health Econ Health Policy, 2018, 16(6): 819-836.
40. Janis IL. Groupthink: psychological studies of policy decisions and fiascoes (2nd edition). Boston: Houghton Mifflin, 1982.
41. Shayo EH, Norheim OF, Mboera LE, et al. Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania. Int J Equity Health, 2012, 11: 30.
42. Gibson JL, Martin DK, Singer PA. Priority setting in hospitals: fairness, inclusiveness, and the problem of institutional power differences. Soc Sci Med, 2005, 61(11): 2355-2362.
43. Kao AB, Berdahl AM, Hartnett AT, et al. Counteracting estimation bias and social influence to improve the wisdom of crowds. J R Soc Interface, 2018, 15(141): 20180130.
44. Kahan JP, Morton SC, Farris HH, et al. Panel processes for revising relative values of physician work. A pilot study. Med Care, 1994, 32(11): 1069-1085.
45. Simera I, Moher D, Hoey J, et al. The EQUATOR Network and reporting guidelines: helping to achieve high standards in reporting health research studies. Maturitas, 2009, 63(1): 4-6.
46. Jansen MPM, Baltussen R, Bærøe K. Stakeholder participation for legitimate priority setting: a checklist. Int J Health Policy Manag, 2018, 7(11): 973-976.
47. Bae EY, Hong JM, Kwon HY, et al. Eight-year experience of using HTA in drug reimbursement: South Korea. Health Policy, 2016, 120(6): 612-620.
48. National Institute for Health and Care Excellence (NICE). Guide to the technology appraisal and highly specialised technologies appeal process. 2023.
49. Sibbald SL, Singer PA, Upshur R, et al. Priority setting: what constitutes success. A conceptual framework for successful priority setting. BMC Health Serv Res, 2009, 9: 43.
50. Mercer RE, Chambers A, Mai H, et al. Are we making a difference? A qualitative study of patient engagement at the pan-canadian oncology drug review: perspectives of patient groups. Value Health, 2020, 23(9): 1157-1162.
51. Oortwijn W, Determann D, Schiffers K, et al. Towards integrated health technology assessment for improving decision making in selected countries. Value Health, 2017, 20(8): 1121-1130.
52. Pinilla-Dominguez P, Pinilla-Dominguez J. Deliberative processes in health technology assessment of medicines: the case of Spain. Int J Technol Assess Health Care, 2023, 39(1): e50.
53. Chen Y, Zhao K, Liu G, et al. Health technology assessment to inform decision making in China: progress, challenges, and sustainability. BMJ, 2023, 381: e068910.

Chinese Journal of Evidence-Based Medicine

Deliberative processes for health technology assessment: interpretation of the guideline from the Joint HTAi/ISPOR Task Force

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