Health Technology Assessment (HTA) in India and MTAB

The UPA Government had decided to establish a Medical Technology Assessment Board (MTAB) under the Department of Health Research (DHR) in Ministry of Health & Family Welfare in 2012. This body was established with key objectives such as:

• To encourage and standardize the cost effective health interventions to reduce cost and variance in patient care.
• To reduce overall out of pocket expenditure in medical treatment.
• To streamline the medical reimbursement procedures
• To be a part of overall regulatory, promotional structure being established in the DHR to accelerate indigenous production of health products, instruments or medical devices that are vital for providing cost effective healthcare.

However, the body remained a non-starter till December 2015. In December 2015, the NDA Government appointed an advisory group under Dr. V M Katoch {former secretary DHR} to bring MTAB in life. Currently, this board is yet to be fully established. India also does not have a formal Health Technology Assessment (HTA) programme as of now.

Why MTAB was in news?

It was in news as the Department of Health Research (DHR) had recently signed a MoU with National Institute of Care and Excellence (NICE) of the United Kingdom for help and capacity-building in Universal Health Care (UHC). The government is also in process of joining the online network of Thailand’s Health Intervention and Technology Assessment Programme (HITAP) which was established to offer health coverage to all Thai people through careful selection of interventions and packages.

What is Health Technology Assessment (HTA)?

HTA is basically a multidisciplinary policy approach which uses clinical effectiveness, cost-effectiveness, policy and ethical perspectives to provide insights and evidence upon which rational policy decisions on the usage of health technology can be made. HTA can be applied for either a single technology (such as a drug or device) or complex interventions (such as rehabilitation). It can be used for individual patient care or public health.

How Health Technology Assessment Works?

HTA is used as a tool to enable the assessment and comparison of health technologies using same metric of cost-effectiveness. Its outcome results in benefit of the patient as well as technology producers because only those technologies which are cost effective are promoted for widespread use.

What is status of Health Technology Assessments in India?

In India, policy decision making process in healthcare is complex due to multiplicity of organizations with overlapping mandates. Generally, the decision making is neither evidence based nor tries to bridge the gap between evidence and policy. While HTA is frequently used in other countries including some of the poor countries, India is yet to launch a formal HTA programme. As there is an incremental growth in  healthcare  products and services, there is a need for innovation in affordable medical devices and interventions also. Thus, any move toward, universal healthcare would need a proper HTA system in place which focuses on evidence-based decision making in healthcare policy.

What should be the framework of establishing HTA in India?

The Government needs to establish HTA as an independent process free of technology producers and medical service providers. The HTA needs to be properly linked with the Policy-making to ensure that the population gets better access to cost effective healthcare.

What is HITAP and What India can learn from it?

Health Intervention and Technology Assessment Program (HITAP) was established in 2007 in Thailand as a Non-Profit organization. Its responsibility is to appraise various health technologies and programs as a social health policy. It is also a part of International Health Policy Program (IHPP), Thailand.

The HITAP International Unit (HIU) has also supported other countries for capacity building and Health Technology Assessment (HTA). It can help India in setting up a proper and formal HTA process in the country as a milestone towards Universal Healthcare. The recent MoU is a right step in that direction.

Further Reference

• Health technology assessment in India: The potential for improved healthcare decision-making {link}
• NITI Aayog: Shift Towards Evidence Based Policy Making {Link}