Day 1 was opened by Francis Ruiz of GHDG and Prof. Karen Hofman of PRICELESS and focused on sharing experiences of the use of evidence in policy making in different country contexts: South Africa, Thailand, China, India, Cambodia and the UK. Participants at the workshop included academics from South Africa, representatives from the South African Department of Health, the WHO, and the Bill and Melinda Gates Foundation (BMGF), plus the country representatives who spoke about their specific contexts. In exploring the ‘HTA journeys’ of different countries, participants learnt about the main drivers for HTA, the factors involved in establishing a framework for HTA informed decision making (e.g. political will, legislation), and what HTA was used for. Netnapis Suchonwanich of HITAP, Thailand, and former Deputy secretary-general at National Health Security Office highlighted for example, that successful structures for incorporating evidence into policy can be established in resource constrained settings where there is a commitment to UHC. Indeed, HTA can be considered an important tool in ensuring the affordability of any universal benefits package devised.

Day 2 focused on a ‘deeper dive’ into the factors that need to be considered when establishing HTA ‘agencies’ with a focus on the ongoing work in establishing iDSI HTA hubs in China, South Africa and India. iDSI hubs are an important mechanism for making iDSI goals, particularly in-country support, more responsive, scale-able and sustainable. These hubs could also serve as centres of regional support. Each of the iDSI HTA hub centres are at different stages of development – it was announced for example at the meeting that the China hub would be launched next month. Damian Walker of BMGF highlighted the importance of taking an in-country focus to hub development, so that the necessary elements can be put in place to allow for effective regional support, as was demonstrated by the experience of Thailand’s HITAP, one of the core partners of iDSI.

Day 3 focused on identifying areas of further collaboration among all the participants represented at the workshop. Areas of cooperation included joint research, placements and study tours.

The full agenda for the workshop can be found here. All the presentations from day 1 and day 2 can be found here.

The delegation was led by Mr. Zhang Laiming, Vice President (Vice Minister), of the Development Research Center of the State Council (DRC) and their Imperial session formed part of a bigger visit to various public sector bodies and think tanks in the UK and will inform DRC’s current thinking on  “deepening the reform of social security and welfare system in China”. This is the latest of a series of visits and exchanges between DRC and the GHD team (formerly NICE International).”

The Prosperity Fund is one element of the UK’s total overseas development commitment, and in China it is focussed on promoting economic reform and growth while supporting the delivery of China’s 13th Five Year Plan (2016-20).

At the official launch meeting there were opening speeches by Wei Fu (Deputy Director of CNHDRC) and Rachel Ainley (Senior Policy Officer, Health and Social Care, British Embassy) to an audience of over 40 people, including representatives from the National Health and Family Planning Commission (NHFPC) and the British Embassy in Beijing. Representatives from Huangdao and Xiamen – the two pilot sites in the project – described their experiences to date in improving the management of patients with chronic diseases such as diabetes and hypertension, with an emphasis on using IT systems to support integration between hospitals and community health centres, and in developing criteria for patient referral and outcome assessment. Deputy Director General Wei, which can be found here,  and Deputy Director General Hong, which can be found here, of the Health and Family Planning Commission of Qingdao and Xiamen respectively, set out the strategy and aims of their integrated care initiatives in the pilot areas including the objective of reducing unnecessary hospitalisation, presenting some initial findings where quality and efficiency have improved.

Prof Kun Zhao of the CHNDRC provided background to the project, noting that a key aim of this work is to develop a standardised approach to developing clinical guidelines and any derived quality measures in China, and applying it to existing care pathways and guidelines on hypertension and diabetes currently in use in Xiamen and Qingdao. Her presentation can be found here. Francis Ruiz from GHD, presented on international experience in explicit priority setting and health technology assessment, stressing how HTAs and clinical guidelines can be used to improve frontline practice through the development of targeted quality measures linked when appropriate to financial incentives. His presentation is here.

The launch concluded with a presentation from Dr Charles Young, Chief Medical Officer of Capita Healthcare Decisions, who along with GHD are involved in the activities associated with this Prosperity Fund project. Dr Young described Capita’s work in decision management, particularly their expertise in nurse-led telephone triage and clinical record management. Implementation of Capita’s decision support system has contributed to reduced primary care referrals and savings of over £213 million to the UK NHS. The previous day Capita delivered a detailed workshop on their decision management system including a demonstration of their software to an audience of policy makers, clinical professionals and IT specialists. This highlighted the potential benefits of clinical IT systems linked with algorithms based on evidence of best practice, to effectively triage patients and support better referral decisions. Attendees at this workshop included representation from Ping An Health Insurance, who also provided support for the event. They have a strong interest in the role of clinical guidelines and decision support tools in supporting the services they provide both within and outside China. Chinese coverage of this event can be found here.

Work on developing the tariff was led by researchers based at Padjadjaran University in Bandung, Indonesia and Erasmus University, Netherlands, with support from the EuroQol group. Fredrick Purba (Faculty of Psychology, Padjadjaran University, and Department of Psychiatry, Erasmus Medical Center Rotterdam) was the lead researcher on the project, and during the symposium he outlined the methods and findings to an audience that included academics from a variety of Indonesian institutions, and representatives from HITAP, WHO and the Indonesian MoH.

Given the importance of this work in supporting the development of HTA in Indonesia, Francis Ruiz (Global Health and Development Group at Imperial College) aimed to contextualize the research by highlighting its role in facilitating in the context of supporting evidence-based coverage decisions, and the broader requirements for successful HTA with a focus on the Asia Pacific region. Drg. Armansyah of the Centre for Health Financing and Health Insurance (Pusat Pembiayaan dan Jaminan Kesehatan, PPJK), the HTA secretariat at the MOH, provided a background to HTA in Indonesia and the latest developments in process and methods. In 2013, iDSI through one of its core partners, the Thai HTA body HITAP, began its engagement with Indonesian authorities with the aim of strengthening its nascent HTA programme, and since then has seen the production of several HTAs. Next steps in the engagement will include continuing to support the Indonesian authorities in refining its methods and processes for HTA, including developing a framework for how any outputs from HTA could be implemented in the system. In addition, colleagues from the Global Health Team at the University of York have embarked on a project to estimate an Indonesian relevant cost-effectiveness threshold that could inform decision rules for HTA-informed policy making. Indonesia’s recent health reforms have provided a rich source of accessible data that can be can be exploited in ways suitable for the purpose of within-country threshold estimation.

In a follow-up newsletter, the chair of QOLMARI, Prof Jan Passchier, discussed the seminar, as well as future plans. The newsletter can be found here.

From 25th – 27th July 2016, a workshop was jointly convened by DHR, Government of India, The Indian Council of Medical Research (ICMR), and iDSI partners: Imperial College’s Global Health and Development Group and HITAP, to raise awareness of this initiative to institutionalise HTA in India.

• The first day of the workshop brought policy makers, academics, health practitioners, and public and private health insurance providers together to discuss the initiative and how it can be best implemented to support India’s Universal Health Coverage Agenda. Read the HTA workshop report here.
• Days two and three were run as a participatory workshop exploring the process for topic selection for HTA in India. Participants generated ideas on how topics could be identified and prioritised, how different stakeholders could be involved and the process for final topic selection. Read the topic selection workshop report here.

Dr Suwit spoke about the Thai experience of achieving universal access to affordable quality healthcare, outlining some of the challenges faced by policy makers and offering his own advice and experience of how to ‘move the mountain’ towards sustainable UHC.

A video recording of the lecture is now available to view online.

Now the Global Health and Development Group, Kalipso Chalkidou and her team will continue to lead on iDSI from their new home.

Watch Lord Ara Darzi’s video message welcoming the team to Imperial College and read more about the move here.

For information about the team’s work prior to September 2016 (as NICE International), please see here.