NICE International colleagues, together with local partners at the State- and National- level, are working to build capacity for HTA in India and support its transition towards Universal Health Coverage.
- Joint Steering Committee to advise on the implementation of HTA in India
- Priority-setting and HTA workshop, Delhi, October 2014
Joint Steering Committee to advise on the implementation of HTA in India
Under the terms of an existing MoU between NICE and the MOHFW Department of Health Research (DHR), Dr Francoise Cluzeau and Dr Laura Downey joined meetings with Dr Soumya Swaminathan, Joint Secretary and Director General of the Indian Council of Medical Research (ICMR), to discuss progress with the Joint Steering Committee (JSC).
The JSC is chaired by Dr Virender S. Chauhan and membership comprises senior colleagues from DHR, ICMR, NHSRC, iDSI and NICE International. Its role is to link in with the soon to be established Medical Technology Advisory Board (MTAB), to provide guidance and advice on how India can implement a system for health technology assessment and priority setting. Meetings on 16 December 2015 outlined a potential work programme for 2016, including training (Health Economics) and HTA demonstration projects.
This process will be a significant step towards Universal Health Coverage for India, improving the way that the health budget is spent by prioritising cost effective practices. It will also be an exciting opportunity for NICE International to be involved in the rapidly advancing Indian health system.
Priority-setting and HTA workshop, Delhi, October 2014
To raise awareness of the principles of active priority-setting, NICE International organised a high-level workshop in New Delhi, co-hosted with the World Bank and the Ministry of Health and Family Welfare (MOHFW), India, with funding from the DFID Health Partnership Scheme.
Over 100 stakeholders from India’s health sector attended the workshop, “Better Decisions for Better Health: Priority Setting & Health Technology Assessment for Universal Health Coverage in India”
Representatives included senior policymakers, state representatives, research institutions, development agencies and industry representatives. International speakers also shared UK, Asian and African experiences of priority-setting.
The workshop followed two days of the World Bank’s forum, which highlighted the importance of prioritising primary care for universal health coverage. NICE has earlier this year hosted a successful study visit on priority-setting and HTA for senior central and state policymakers, with World Bank funding.
Making Each Rupee go a Longer Way
There is huge potential for priority-setting to improve population health for 1.2bn people, to help India make best use of every rupee in order to achieve their vision of ‘health for all’. The issue is particularly important for India as it ramps up health spending beyond 4% of its GDP (60% of which borne by households, susceptible to catastrophic expenses), and as the government moves forward on its ambitious agenda of providing health insurance to all under the National Health Assurance Mission.
Given finite health budgets, the key will be to determine which services should be prioritised so that health spending can bring the greatest benefit to the people.
“We need to make sure the rupee goes the longest way”, said Prof Ranjit Roy Chaudhury, advisor to the MOHFW, and a leading pharmacologist and champion of rational drug use in India.
Developing a core package of services
Under the National Health Assurance Mission, the government plans to assure a core package of health services. Systematic priority setting will help the government decide which new services, drugs, or technologies should be added to this package and which should be removed. Determining these priorities will not be easy. For instance, how do you choose between buying 5,000 infant warmers or an MRI scanner?
Emphasising the need for informed decisions, Lov Verma, Secretary, MOHFW said at the workshop that priority-setting is important as India is at a crossroads. “What should our priorities be? There are so many competing interests and it’s important we use evidence to [set priorities].”
Sir Andrew Dillon, Chief Executive of NICE, reaffirmed NICE’s commitment to support MOHFW: “Everywhere in the world, policymakers have to make difficult choices about how best to use their resources to improve people’s health”. Mr. Verma also announced that the Medical Technology Assessment Board created under the Department of Health Research will have an important role in priority setting.
Welcoming the announcement, Dr. Katoch, Secretary, Department of Health Research said that the government has been exploring tools to help set priorities, and found the NICE model closest to their thinking. Accordingly, they have signed a memorandum of understanding with NICE for their support in building expertise in this task.
NICE and HTA
NICE is an independent body that provides authoritative guidance and standards for the NHS in England. NICE International, its not-for-profit division, leads the International Decision Support Initiative (iDSI, www.idsihealth.org ). The role of iDSI is to guide policymakers across the world towards more efficient and effective strategies for better health.
NICE uses a tool – known as health technology assessment (HTA) – to compare healthcare services and interventions (from public health interventions to individual drugs and technologies) in terms of health benefits, value for money, social and ethical considerations.
For example, HTA could help policymakers choose between funding HPV vaccines and universal screening for cervical cancer; or to invest in smoking cessation programs. HTA provides a transparent and scientific process to guide policymakers towards better decisions that lead to higher quality healthcare services.
This project is part of the Health Partnerships Scheme programme
Elsewhere in the news
Prioritising services key to health spending: Experts
The Economic Times, October 2014
India's universal healthcare rollout to cost $26 bln: official
Daily Mail online, October 2014
India: Universal Healthcare Rollout Will Cost $26bn
International Business times, October 2014
India: Universal Healthcare Rollout Will Cost $26bn
Reuters.com, October 2014