3 - (after hierarchy of evidence until before decision model)

Expert evidence or expert opinion

are valid and acceptable sources of information to complement published literature, or in cases when published research evidence is missing or inadequate

de novo

conducting a _____ systematic review which may take up to more than one year is not always feasible particularly in emergency situations where there is a need to balance rigor with practical considerations…

rapid reviews

shall be conducted for health technologies relevant to a public health emergency as defined RA 11223

Rapid reviews (RR)

a form of knowledge synthesis that follows the systematic review process, but the components of the process are simplified or omitted to produce information in a timely manner. They may vary in scope, methodology, and timeline of preparation.

staged search

usually employed in rapid reviews with the objective to first identify existing systematic reviews before studies with other study designs.

4-12 weeks

timeframe of rapid review

8-12 months

timeframe of systematic review

1

no. of databases of rapid review

3

no. of databases of systematic review

may/may not be searched

in rapid review, what is done with grey literature?

must be searched

in systematic review, what is done with grey literature?

common restrictions

search strategy in rapid review

no restrictions

search strategy in systematic review

optional

in rapid review, what is done with independent review?

required

in systematic review, what is done with independent review?

narrative +/- meta-analyses

evidence synthesis of systematic review

critical appraisal

use of a systematic method to evaluate the methodological quality of studies assessing both their strengths and limitations, therefore, leading to the judgment on their internal validity and the reliability of the study’s findings and conclusions.

critical appraisal

an important step in HTA in determining the extent to which biases in the design and conduct of the study are likely to have affected the results, and therefore, potentially overestimate or underestimate the effects of the interventions

critical appraisal

This step shall guide the overall interpretation of data, and the formation of conclusions and recommendations with consideration to the strength of the evidence presented.

narrative synthesis

done to summarize the results of all included studies taking into account the similarities and differences across studies especially on the important clinical outcomes and their measures of effect with their respective p values and confidence intervals. Results should also be presented in summary tables.

economic evaluation

the comparative analysis of alternative courses of action in terms of both their costs (resource use) and consequences (outcomes and effects)

economic evaluations

are important to inform priority-setting and resource allocation decisions in healthcare

eligibility criteria (from PICOT)

used as basis for the inclusion and exclusion of studies from the total search

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)

The results of the study selection should also be reported using the ______ flow diagram.

Standard data extraction sheets

should be designed and used to extract the following information from the included studies

critical appraisal tool for EEs
Consolidated Health Economic Evaluation Reporting Standards (CHEERS)

The methodological quality of the included studies should be assessed using the ______ by Drummond et al., 2015 and the reporting standard _______

de novo economic evaluations

When there is a need to assess the value for money of health technologies compared with alternatives relevant to the Philippine setting, _______ may be conducted

budget impact analysis (BIA)

financial approach designed to estimate, over a defined time horizon, the financial consequences of adopting a health intervention.

DOH
PhilHealth

The objective of BIA is to increase the awareness of ___ or ____ policymakers with regard to the financial impact of introducing a new technology, and to aid in budget or service planning of government and/or social insurance.

public payer perspective
CEA
CUA

All BIAs shall use _____ which shall cover all costs borne by the government. This is required, along with the ____or ____

lower

____ annual percent changes in the budget is always preferred

cost-utility analysis (CUA)

The preferred type of economic evaluation in the reference case

cost utility analysis (CUA)

It is preferred since it allows the comparison of health gains and costs across different diseases and interventions, and therefore, allows decision makers to make efficient allocation of resources while maximizing health gains.

cost-effectiveness analysis (CEA)

A _______ reporting benefits in terms of natural health units should be reported alongside the CUA to further characterize the clinical benefit profile of the health technology although it does not allow for broad comparisons across diseases and interventions.

HRQOL (Health Related Quality of Life)

CEA reporting benefits in terms of natural health units alone may be acceptable in situations where ______ data are not available, provided that clinically meaningful outcomes are used

cost minimization analysis (CMA)

may be sufficient where the intervention and the comparator have been shown to be equivalent or not significantly differently in terms of clinically relevant health outcomes.

cost minimization analysis (CMA)

an analysis that focuses on calculating and comparing costs to project the least costly health technology

cost benefit analysis (CBA)

an analysis that expresses all outcomes (health and non-health) valued in monetary rather natural or utility units

cost benefit analysis (CBA)

generally not used because of controversy in assigning a monetary value on life

cost effectiveness analysis (CEA)

an analysis that measures incremental cost per extra unit of health outcome achieved (incremental cost/unit of health outcome)

cost utility analysis (CUA)

an analysis used to determine the cost in terms of utilities, especially quantity or quality of life

cost minimization analysis (CMA)

shall be used for health technologies whose clinical evidence are equivalent or non-inferior to comparator

cost utility analysis (CUA) or cost effectiveness analysis (CEA)

shall be used for health technologies whose clinical evidence are superior to the comparator

Costing

the estimation of the cost of health interventions or services in a specific context (i.e., location, time period, population).

Direct costs

the expenses incurred because of the illness (including medical care, travel costs, etc.)

Healthcare costs

cost of all (medical) goods and services used for the provision of healthcare which are provided by the healthcare system, and further subdivided as fixed (covering capital, labor and overhead costs), semi-fixed and variable costs

Non-Healthcare costs

cost of all goods and services used for the provision of healthcare which are not directly provided by the healthcare system

Indirect cost

the value of lost production because of reduced working time

Intangible cost

the cost of pain and suffering associated with the treatment