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DOI: 10.1055/s-0041-1740536
Application of Health Technology Assessment for Oncology Care in India: Implications for Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana
Sources of Support No support in the form of grants, equipment, or drugs was obtained to prepare this manuscript.Abstract
A health system is considered efficient when it provides maximum health gains to the population from the available resources. Newer drugs, diagnostics and treatment strategies aim to improve the health of the population, however, they come at an increased cost. Therefore, for an efficient health system, it needs to be decided if the extra cost being incurred is justified to achieve the extra health gains. In this regard, health technology assessment (HTA) helps to make evidence informed decisions by evaluating relative cost and benefits of the available interventions. Economic evidence generated by HTA can also be used in framing standard treatment guidelines (STGs) for high-cost cancer care. In multi-payer systems like India, the decisions regarding the clinical management of patients are taken based on the patients' ability to pay, which creates inequities in utilization of healthcare. Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PM-JAY) offers an opportunity to ensure equity as it reduces financial barriers, besides having a potential to affect efficiency by including only cost-effective interventions in the benefit package. As a result, informed clinical decisions based upon HTA evidence can make cancer treatment more efficient, equitable and affordable for the patients.
Keywords
cost-effectiveness - health economics - health insurance - Health Technology Assessment - medical oncology - priority setting - universal health coverageAuthor Declaration
The manuscript has been read and approved by all the authors. All the authors meet the requirements for authorship, and each author believes that the manuscript represents honest work.
Publikationsverlauf
Artikel online veröffentlicht:
10. Dezember 2021
© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 World Health Organization, The World Health Report 2000. Health Systems: Improving Performance. Geneva, 2000. https://apps.who.int/iris/handle/10665/42281. Accessed December 1, 2021
- 2 World Health Organization. WHO | Health technology assessment. [online]. https://www.who.int/medical_devices/assessment/en/ Accessed Accessed December 1, 2021.
- 3 Prinja S, Sundararaman T, Muraleedharan VR. Cost-effectiveness threshold and health opportunity cost. Econ Polit Wkly 2020; 55 (02) 19
- 4 Chi YL, Blecher M, Chalkidou K. et al. What next after GDP-based cost-effectiveness thresholds?. Gates Open Res 2020; 4: 176 DOI: 10.12688/gatesopenres.13201.1. eCollection 2020
- 5 World Health Organization. WHO List of Priority Medical Devices for Cancer Management. Geneva: World Health Organization; 2017
- 6 National Comprehensive Cancer Network. 2021 NCCN Guidelines: Treatment by Cancer Type. [online]. <https://www.nccn.org/guidelines/category_1> Accessed December 1, 2021
- 7 ICMR Consensus Documents for Cancer Management. India Against Cancer. http://cancerindia.org.in/icmr-consensus-documents-for-cancer-management/ Accessed December 1, 2021
- 8 National Cancer Grid Draft Guidelines. 2020. Draft Guidelines 2020 - NCG. https://tmc.gov.in/ncg/index.php/guidelines/draft-guidelines-2020 Accessed December 1, 2021
- 9 Sung H, Ferlay J, Siegel RL. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (03) 209-249 Epub ahead of print 10.3322/caac.21660
- 10 Guidelines Detail- Breast Cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1419 Accessed December 1, 2021
- 11 Consensus Document for Management of Breast Cancer. Indian Council of Medical Research. [online]. https://main.icmr.nic.in/sites/default/files/guidelines/Breast_Cancer.pdf Accessed December 1, 2021
- 12 Gulia S, Kannan S, Badwe R, Gupta S. Evaluation of 1-year vs shorter durations of adjuvant trastuzumab among patients with early breast cancer: an individual participant data and trial-level meta-analysis. JAMA Netw Open 2020; 3 (08) e2011777 DOI: 10.1001/jamanetworkopen.2020.11777.
- 13 Ghosh J, Gupta S, Desai S. et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011; 48 (04) 391-396
- 14 Vijaykumar DK, Arun S, Abraham AG, Hopman W, Robinson AG, Booth CM. Breast cancer care in South India: is practice concordant with national guidelines?. J Glob Oncol 2019; 5: 1-7
- 15 Gupta N, Verma RK, Gupta S, Prinja S. Cost effectiveness of trastuzumab for management of breast cancer in India. JCO Glob Oncol 2020; 6: 205-216
- 16 Gupta N, Verma RK, Prinja S, Dhiman RK. Cost-effectiveness of sorafenib for treatment of advanced hepatocellular carcinoma in India. J Clin Exp Hepatol 2019; 9 (04) 468-475
- 17 Gupta N, Prinja S, Patil V, Bahuguna P. Cost effectiveness of temozolamide for treatment of glioblastoma multiforme in India. J Global Oncol 2021; 7: 108-117 Jan 15: DOI https://doi.org/10.1200/GO.20.00288
- 18 Oliver A. The single-payer option: a reconsideration. J Health Polit Policy Law 2009; 34 (04) 509-530
- 19 Owen L, Pennington B, Fischer A, Jeong K. The cost-effectiveness of public health interventions examined by NICE from 2011 to 2016. J Public Health (Oxf) 2018; 40 (03) 557-566
- 20 NHS England. NHS England strikes deal to make innovative breast cancer drug routinely available on the NHS [Internet]. England.nhs.uk. 2021 [cited 18 July 2021]. https://www.england.nhs.uk/2017/06/breast-cancer-drug-routinely-available-on-the-nhs/. Accessed December 1, 2021
- 21 National Sample Survey Office. Health in India- NSS 75th Round [Internet]. New Delhi: National Sample Survey Office, Ministry of Statistics and Programme Implementation; July 2020. http://mospi.nic.in/sites/default/files/publication_reports/NSS%20Report%20no.%20586%20Health %20in%20India.pdf. Accessed December 1, 2021
- 22 National Health Accounts Technical Secretariat. National Health Accounts Estimates for India 2016–17 [Internet]. New Delhi: National Health Systems Resource Centre; 2020. http://nhsrcindia.org/sites/default/files/FINAL%20National%20Health%20Accounts%202016- 17%20Nov%202019-for%20Web.pdf. Accessed December 1, 2021
- 23 Prinja S, Kumar MI, Pinto AD, Jan S, Kumar R. Equity in hospital services utilisation in India. Econ Polit Wkly 2013; xlviiI (12) 52-58
- 24 Prinja S, Aggarwal AK, Kumar R, Kanavos P. User charges in health care: evidence of effect on service utilization & equity from north India. Indian J Med Res 2012; 136 (05) 868-876
- 25 Prinja S, Kanavos P, Kumar R. Health care inequities in north India: role of public sector in universalizing health care. Indian J Med Res 2012; 136 (03) 421-431
- 26 Prinja S, Chauhan AS, Karan A, Kaur G, Kumar R. Impact of publicly financed health insurance schemes on healthcare utilization and financial risk protection in India: a systematic review. PLoS One 2017; 12 (02) e0170996
- 27 Prinja S, Downey LE, Gauba VK, Swaminathan S. Health technology assessment for policy making in India: current scenario and way forward. Pharmacoecon Open 2018; 2 (01) 1-3
- 28 Downey LE, Mehndiratta A, Grover A. et al. Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India. BMJ Glob Health 2017; 2 (02) e000259 DOI: 10.1136/bmjgh-2016-000259.
- 29 Bahuguna P, Prinja S, Lahariya C. et al. Cost-effectiveness of therapeutic use of safety-engineered syringes in healthcare facilities in India. Appl Health Econ Health Policy 2020; 18 (03) 393-411 DOI: 10.1007/s40258-019- 00536-w.
- 30 Chugh Y, Dhiman RK, Premkumar M, Prinja S, Singh Grover G, Bahuguna P. Real-world cost-effectiveness of pan-genotypic Sofosbuvir-Velpatasvir combination versus genotype dependent directly acting anti-viral drugs for treatment of hepatitis C patients in the universal coverage scheme of Punjab state in India. PLoS One 2019; 14 (08) e0221769
- 31 Prinja S, Rajsekhar K, Gauba VK. Health technology assessment in India: reflection & future roadmap. Indian J Med Res 2020; 152 (05) 444-447
- 32 Kaur G, Prinja S, Lakshmi PVM, Downey L, Sharma D, Teerawattananon Y. Criteria used for priority-setting for public health resource allocation in low- and middle-income countries: a systematic review. Int J Technol Assess Health Care 2019; 35 (06) 474-483
- 33 Thokala P, Devlin N, Marsh K. et al. Multiple criteria decision analysis for health care decision making–an introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health 2016; 19 (01) 1-13
- 34 Prinja S, Bahuguna P, Pinto AD, Sharma A, Bharaj G, Dhiman V, Tripathy JP, Kaur M, Kumar R. Cost of Universal Health Care Provision in India: a Model-Based Analysis. PLoS One 2012; 7 (01) e30362
- 35 Singh D, Prinja S, Bahuguna P. et al. Cost of scaling-up comprehensive primary health care in India: Implications for universal health coverage. Health Policy Plan 2021; 36 (04) 407-417