1. Health Technology Assessment in India
Dr. Himanshu Baweja
Consultant-WHO Country Office
Dr. Madhur Gupta
Technical Officer-Pharmaceuticals
WHO Country Office
India

2. World Health Organization Executive Board paper on Health Intervention and Technology Assessment in Support of UHC
The definition of HTA, according to the WHO Executive Board paper EB134/30 is: “…..is the systematic evaluation of properties, effects and/or impacts of health technologies and interventions. It covers both the direct, intended consequences of technologies and interventions and their indirect, unintended consequences. The approach is used to inform policy and decision-making in health care, especially on how best to allocate limited funds to health interventions and technologies. The assessment is conducted by interdisciplinary groups using explicit analytical frameworks, drawing on clinical, epidemiological, health economic and other information and methodologies. It may be applied to interventions, such as including a new medicine into a reimbursement scheme, rolling-out broad public health programmes (such as immunization or screening for cancer), priority setting in health care, identifying health interventions that produce the greatest health gain and offer value for money, setting prices for medicines and other technologies based on their cost–effectiveness, and formulating clinical guidelines”.
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3. Introduction:
India is among the countries with the highest out of pocket expenses on healthcare in recent years. The way in which these available resources are allocated across competing priorities is crucial So, there is a growing recognition of the need for priority setting in India as it aims to achieve Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY)- Universal Health Coverage through Health technology assessment.

4. History of Health Technology Assessment:
Health Technology Assessment was first started 30 years ago in World Health Organization and two regional offices (EURO and AMRO), considering HTA a way to strengthen evidence based selection and rational use of health technologies.
Recently in 2013, WHO publications and Resolutions indicate that HTA is a tool to further advance the implementation of Universal Health Coverage (UHC) in terms of deciding getting right intervention at lowest possible cost.
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5. Health Technology Assessment activities done at WHO:
Health Technology Assessment Survey: Information and results to all member states.
Health financing for Universal Coverage
WHO guidelines approved by the guidelines review Committee of HTA
Evidence informed policy making
Development of HTA Capacity in Member states through advocacy and raising awareness on Utility of HTA for policy makers.

6. Health Technology Assessment activities done at WHO:
WHO Country Office for India was organizing International fellowship program on Health Technology Assessment at Indian Institute of Technology, Madras for training of Health Care and Public Health Specialists in India
This Unique fellowship program brings together Engineers, Researchers, Healthcare Professionals, Industry Experts and Government to form a Vibrant and Fertile innovative ecosystem for Health Technology Assessment.

7. First HTA Compendium by WHO Country Office:
The Health Technology Assessment Compendium also launched jointly by WHO Country Office and NHSRC in as an outcome of this HTA fellowship program
This First Compendium of HTA is an evidence based approach to technology related policy making in healthcare. It also highlights the most essential health technologies required today for responding to India disease burden

8. Defining decision space
5 Step-HTA process
How do we decide if the evidence is strong enough to support a decision? What are our recommendations?
How is the decision implemented and monitored?
What is the Decision problem? Topic identification and Prioritisation
Defining decision space
Analysis
Appraisal
Decision making
Implementation
What is the decision to be taken?
What is the required analysis needed to help answer the decision problem?

9. Health Technology Assessment in India(HTA In):
To facilitate the process of transparent and evidence informed decision making in the healthcare , Government of India has created an institutional arrangement called the Health Technology Assessment in India(HTA In) under the Department of Health Research.
It is entrusted with the main responsibility to collate and generate evidence related to the Clinical effectiveness , cost-effectiveness, and safety of medicines, vaccines and health programs using the Health Technology Assessment approach.
In Oct0ber-2018, DHR also Launched Manual on HTA.

10. Seven Resource Hubs Established under DHR:
Postgraduate Institute of Medical Education and Research(PGIMER), Chandigarh
Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST),Kerala
National Institute for Research in Tuberculosis(NIRT), Chennai
Regional Medical Research Centre(RMRC), Bhubaneswar
Indian Institute of Public Health(IIPH), Shillong
Kalam Institute of Health Technology , Vizag
National Health Systems Resource Centre , Delhi

11. Conclusion:
The drive to achieve Universal Health Coverage raises the need to choose and manage effective technologies that are to be adopted within countries’ health systems, particularly in a context of limited resources.
Developing and strengthening national capacity will have to build on established best practices, information exchange and collaborative approaches to make the best use of limited resources and yield robust scientific assessments.
The Health Technology Assessment in India aims to maximize access to quality healthcare at minimum cost to the people of the country.

12. Thank You!
Disclosure : We disclose that we do not have any source of funding and conflict of interest in presenting this topic.