AHTAPol – Agency for Health Technology Assessment in Poland
"By providing high quality information on the costs, effectiveness, and broader impact of health care technologies, we facilitate informed decisions on funding healthcare benefits by reinforcing the role of scientific evidence in the decision-making process."
Dr. Wojciech Matusewicz, Director, AHTAPol
History and Structure
The Agency for Health Technology Assessment in Poland (AHTAPol) is a state financed institute established by the Regulation of the Minister of Health in September 2005. AHTAPol serves as an advisory body to support the Minister of Health in the decision-making process.
Core activities of AHTAPol are to produce health technology assessment (HTA) reports and collect, make available, and disseminate information on HTA results, methodologies, and recommendations generated within or outside of Poland. Apart from administrative staff, AHTAPol is comprised of 4 main departments (40 permanent staff):
1. Department of HTA
- Analysis of clinical evidence to assess the efficacy and safety of health technologies
- Economic analyses of health technologies
- Cost-effectiveness analyses of health technologies
- Collaboration with the Consultative Council
2. International Cooperation Coordinator
- Work with international partner institutions involved in HTA
- Prepare materials and papers for international conferences
3. Economic Analysis Department
- Analyze health services costs
- Analyze actual costs of pharmacological therapies
- Improve the methodology for cost assessments of health services
4. Department of Health Services Costs Monitoring
- Monitor the costs of health services
- Review the efficiency of health services
The Consultative Council appraises reports developed by the Department of HTA and makes recommendations on assessed technologies. The AHTAPol Director determines the principles that the Council should follow in making recommendations. Based on the Council's appraisal, the AHTAPol Director presents the final recommendations to the Minister of Health.
The Consultative Council is comprised of 8 members appointed to a 5-year term by the Minister of Health in January 2007. The Council includes external experts (eg, from the National Health Fund, Supreme Medical Council, and Medical Universities Rectors Conference) whose knowledge and experience assure that the Council's responsibilities are fully carried out. The Council held its first meeting in January 2007.
To identify HTA topics and ensure the relevance of its work, AHTAPol collaborates with clinical experts in different fields and relevant policy makers (healthcare decision makers and hospital managers). In evaluating the economics of health technologies, AHTAPol contracts with academic centers. Contractors for economic evaluations and cost-effectiveness analyses of specific medical technologies are selected through a tender process.
The organizational structure of AHTAPol shall be verified in accordance with Transition Facility 2005 Project, Transparency of National Health System Drug Reimbursement Decisions, and shall undergo structural and procedural improvements, as needed, to assess and aggregate evidence according to principles of evidence based medicine (EBM).
Our target audience includes the Minister of Health (to inform decisions on public funding of health technologies, especially controversial, expensive procedures under the Basic Benefits Package) and relevant policy makers, eg, those who decide on contracted services and hospital managers who decide on services provided by their hospital. Our HTA reports aim to provide guidance in offering the highest quality of evidence based health care.
How AHTAPol Works
AHTAPol is responsible for:
- Evaluating healthcare technologies (procedures and interventions, both pharmaceutical and nonpharmaceutical)
- Assessing medical procedures and verifying assessments of medical procedures, with special focus on contracted services
- Collecting, making available, and disseminating information on HTA results, methodology, and recommendations generated within or outside of Poland
- Recommending medical procedures to the Minister of Health
- Performing other duties as delegated by the Minister of Health, eg, coordinate work on the Basic Benefit Package, and coordinate and develop Polish guidelines for producing HTA reports.
AHTAPol collaborates with many entities, including: research/academic centers to evaluate health technologies and EBM; the Office of the Minister of Health and bodies reporting to, or supervised by, the Minister of Health; national consultants in various fields of medicine; scientific medical associations; international organizations with objectives similar to those of AHTAPol; health service providers; and entities governing the medical profession.
AHTAPol intends to have two independent experts review most of our HTA reports prior to publication.
AHTAPol uses the Internet as its main means of communication (www.aotm.gov.pl or www.aotm.eu). All publications are available electronically and free of-charge. Full-text versions of HTA reports are available in Polish, with abstracts in Polish and English. AHTAPol disseminates HTA results in several ways:
- Full HTA reports presenting analyses of clinical effectiveness, cost effectiveness, and budgetary impact
- Economic evaluations including clinical aspects, cost effectiveness, and budget impact
- Budget impact analysis (BIA)
- Preliminary assessments to inform Consultative Council decisions on the necessary scope of analysis/reporting on technologies of interest with evidence collected on the research topic.
Our website intends to inform readers about HTA reports, current initiatives and activities, new projects, publications in the field, and upcoming events. In accordance with its statutory mandate to disseminate evidence based health information and make it easily accessible to the general public, AHTAPol is working to establish a national provision to access the Cochrane Library (worldwide source of evidence on the effects of different forms of health care) starting in year 2007.
Other means to disseminate information about our HTA reports include participation in national and international conferences and workshops, and educational activities and seminars for target groups and the general public.
Original reports will be published in Polish. Some reports will be published in English, depending on budgetary constraints and the relevance of the topic. Abstracts will be available in Polish and English.
Completed HTA report:
PET-CT positron emission tomography in diagnostic oncology compared to other diagnostic technologies financed by public sources in Poland. This 3-part report addresses:
- Cost-effectiveness analysis of PET-CT positron emission tomography and public-financed diagnostic technologies in diagnostic oncology in Poland – clinical and epidemiological aspects
- Cost-effect analysis of the PET-CT system – incremental cost-effectiveness ratio (ICER) analysis of clinical aspects
- Cost-effectiveness analysis of the PET-CT system compared with standard methods in cancer diagnostics – incremental cost-accuracy ratio (ICAR) analysis.
Current Projects (A Selection)
- Collaboration on external partnerships (EUnetHTA, HTAi G-I-N, and ISPOR), Transition Facility 2005 Project, Transparency of the National Health System Drug Reimbursement Decisions in collaboration with the French Ministry of Health
- Cost-utility analysis of disease-modulating drugs (beta interferons and glatiramer acetate) for multiple sclerosis (MS) considered in the draft of the national program for treating patients with MS, 2006-2008
- The use of SPECT imaging with DaTSCAN to evaluate the activity of the nigrostriatal dopaminergic system in patients with clinically uncertain Parkinson's Disease symptoms – economic analysis (with clinical effectiveness analysis, cost analysis, and cost-effectiveness analysis) with budget impact analysis (BIA)
- Management of Pulmonary Arterial Hypertension (PAH) with epoprostenol, iloprost, treprostinil, bosentan, and sildenafil – meta-analysis with BIA
- Endometrial balloon thermoablation
- Laser ablation using KTP laser for patients with benign prostate enlargement (hyperplasia) – cost-effectiveness or cost-utility analysis with BIA
- Ultrasonography imaging using second-generation contrast agent – systematic review and meta-analysis of clinical trials evaluating clinical effectiveness or diagnostic efficacy of the technology and BIA
- Capsule endoscopy
- Hemorrhoidectomy using Longo technique
- Noninvasive coronary angiography using multi-slice computed tomography (MSCT) versus invasive coronary angiography.
As a relatively young organization undergoing organizational and procedural development, AHTAPol will likely benefit from the Transition Facility 2005 Project financed by the EU Commission. The main objectives are:
- Propose structural and procedural improvements for AHTAPol (and other institutions in Poland's health system)
- Provide training courses on assessing and aggregating evidence according to EBM, and on critically appraising health economic analyses, including social, ethical, and other implications – for HTA doers and users separately
- Provide "training for trainers" courses in EBM and HTA.
Description of population served: National
Population served (mil): 38.2
Current HTA budget (mil USD): 3.6
Permanent staff: 40
Ongoing TA projects: 9
Director: Dr. Wojciech Matusewicz
Contact person: Anna Zawada
Agency for Health Technology Assessment in Poland
Agencja Oceny Technologii Medycznych
I.Krasickiego 26 street
02-611 Warsaw Poland