At what point in the life cycle of technologies are HTA reports requested? An analysis of 130 HTA reports in Argentina




Poster session 4


Tuesday 25 October 2016 - 15:30 to 16:00


All authors in correct order:

Ciapponi A1, Ariel B1, Alcaraz A1, Calderón M1, Hernández-Vásquez A1, Augustovski F2, Pichón-Riviere A2
1 Argentine Cochrane Center IECS, Institute for Clinical Effectiveness and Health Policy, Argentina
2 Institute for Clinical Effectiveness and Health Policy (IECS), Argentina
Presenting author and contact person

Presenting author:

Agustín Ciapponi

Contact person:

Abstract text
Introduction: Health technologies (HT) have a natural life-cycle with five stages: research/development, experimental, innovative, general use, and obsolescence/replacement. Health Technology Assessment (HTA) can be useful in all these stages.

Objective: To describe when in the life-cycle of a technology the HTA is requested, based on the experience from an independent Argentinian HTA agency, the Institute for Clinical Effectiveness and Health Policy (IECS), a member of INAHTA (The International Network of Agencies for Health Technology Assessment).

Methods: We analyzed all the reports performed by IECS for a consortium of public, social security and private health care institutions in Argentina and Uruguay during 2014 and 2015.
Two independent researchers evaluated the reports and classified the life-cycle stage of each HT. Discrepancies were solved by consensus.
We considered three categories of HT: experimental stage, non-experimental (innovative, general use stage, non-effective) and obsolescence/replacement (Table 1).

Results: We evaluated 130 HTA reports related to drugs (38%), medical procedures (31%) and diagnostic technology (31%) (Table 2). None were requested at the research/development or obsolescence/replacement stages, 44% concerned the experimental stage and 56% the non-experimental stage. HTAs for drugs and medical procedures were more frequently at the non-experimental stage, and 45/73 (45%) of non-experimental HTs were considered to be non-effective (Figure 1).
We found that 93/130 (72%) HTs were approved by at least one regulatory agency.
The quality of the evidence measured by GRADE (Grading of Recommendations, Assessment, Development and Evaluations) was high in 34%, moderate in 30%, low in 30% and very low in 6%. Nine were HTAs for orphan diseases.
Considering all the HTAs, only 49/130 (38%) had a positive or positive with restrictions for coverage recommendations.

Conclusions: Nearly half of the HTs performed by the main HTA agency in Argentina were evaluated at an experimental stage, when there is no evidence for routine use. Only slightly more than a third of the HTs were finally recommended for wider use.