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News from CADTH, Canada 
In February, CADTH announced with profound regret and sadness the death of Dr. Jill M. Sanders, President and CEO of CADTH. Dr. Sanders passed away peacefully in hospital on February 15th, 2010, following a six month heroic battle with cancer. She led the transformation of CADTH from a small office in 1997, into an agency with a national and international reputation for quality in evidence-based decision making.
Dr. Brian O’Rourke has been appointed as the Acting President and CEO after relinquishing his role as Vice President of the Common Drug Review.
Since the beginning of November 2009, CADTH’s rapid response service, the Health Technology Inquiry Service, produced 120 tailored reports, the Common Drug Review (CDR) received nine new drug submissions, and CADTH’s Health Technology Assessment division published five full technology reports.
As CADTH moves into its third decade and next chapter, it continues to build upon its achievements. By strengthening its governance model, integrating the science directorates, and implementing a comprehensive strategic portfolio management process, CADTH will ensure responsiveness to its stakeholders needs, and that its products and services are relevant, timely and flexible.
Recently, CADTH launched a therapeutic review pilot project for conducting a review of a CDR submission concurrently with a therapeutic review of the same drug class or category as the CDR submission. The final outputs of therapeutic reviews will include recommendations, advice, or a report and conclusions. Expert work in support of CADTH’s optimal therapy efforts also continues to influence decision-making. CADTH has hosted four Café Scientifique events that have explored the practice of self-monitoring of blood sugar by patients with type 2 diabetes. CADTH has also initiated the development of recommendations for non-drug health technologies. In addition, a revised environmental scanning service will focus on supporting jurisdictional needs and cover a broader range of issues.
CADTH is also preparing for its sixth Symposium, in Halifax, Nova Scotia (April 18-20, 2010). This year’s event, themed Evidence, Decisions, Outcomes: Optimizing the Use of Drugs and Health Technologies, promises to be both informative and timely as Canadian and international presenters gather to share their expertise in the production and use of evidence-based information on drugs and other health technologies.
Links:
http://www.cadth.ca/index.php/en/events/symposium-2010
 Click here to contact CADTH
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News from AVALIA-T, Spain 
The Galician HTA agency (avalia-t) has just published three documents for the Spanish National Health System related with Screening information to users: assessment of current situation and establishment of evidence-based information standards: Information to parents about neonatal screening for inborn errors of metabolism, evidence-based information on breast cancer screening and evidence-based information on cervical cancer screening. Moreover, in the framework of the Spanish Clinical Practice Guidelines Program it has published the Clinical Practice Guideline on the management of major depression in children and young people that offer recommendations to professionals for taking care of children and adolescents with major depression in the field of primary health care and hospital care.
The agency has also developed several HTA reports to give support to the Galician HTA Commission, responsible for deciding on the approval of new technologies to be included into the benefit basket : Applicability of sentinel-lymph-node detection and biopsy in the treatment of vulvar cancer and Endobronchial valves in the treatment of diffuse heterogeneous-type pulmonary emphysema. (All of our documents have English summary available)
The Galician HTA Commission can mandate conditional monitoring before incorporating a new technology into daily clinical practical use or approve the technology but recommend a post-introduction observation study to evaluate specific aspects that can be foreseen as problematic when it is generally financed (for example, diffusion, adoption, adequacy of indications, applicability of research results). Currently avalia-t is coordinating four post-introduction observation studies:
- Albumin Dialysis and Molecular Adsorbent Recirculating System (MARS®) in the treatment of liver failure
- Percutaneous Transfemoral or Transapical Aortic Valve Implantation S
- Sacral nerve stimulation for faecal incontinence
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News from NHS-QIS, Scotland, UK
As reported in the last edition, a mainstay of the HTA Programme at NHS Quality Improvement Scotland (NHS QIS) is its support to the Scottish Health Technologies Group (SHTG). We do this in a number of ways: through horizon scanning, undertaking clinical and cost effectiveness analysis and facilitating dissemination and implementation of new technologies.
One of the ways SHTG supports implementation is by producing clinical and resource impact reports, which provide estimates of the resources required and associated financial implications of implementing key recommendations arising from NICE technology appraisals and SIGN guidelines. Important factors in the prioritisation decision are whether the recommendations are likely to require changes to current practice and, if so, whether this is a material change to either the patient pathway or number of patients. Improving implementation should enhance patient care and enable more equitable patient access throughout NHSScotland. For details of the clinical and resources impact reports and costing tools published to date visit our website http://www.nhshealthquality.org/nhsqis/4968.html.
Current projects include: an HTA on the use of topical negative pressure to treat chronic and acute wounds (http://www.nhshealthquality.org/nhsqis/6349.html), which is due to publish in Summer 2010; and Evidence Notes on the use of extracorporeal membrane oxygenation (ECMO) for respiratory distress in adults; evidence on open, laparoscopic and robot-assisted laparoscopic radical prostatectomy for prostate cancer; use of portable three-dimensional ultrasound scanners in diagnosing and treating urinary dysfunction; bariatric surgery; and weight management.
The remit of SHTG also includes disinvestment and NHS QIS is hosting a seminar in May 2010 to consider how it can support NHSScotland in achieving this effectively. We have secured a number of eminent speakers from across the UK to contribute to the event and it has attracted considerable interest from senior executives throughout NHSScotland. Further information is available on our website (http://www.nhshealthquality.org/nhsqis/7369.html) and we hope to circulate a programme for the day in the very near future.
Ongoing developments include considering the future role of SHTG, producing a strategy on adoption of new technologies in NHSScotland, and developing links with other national organisations, for example the National Planning Forum. Further information on the work of SHTG is available on our website at http://shtg.nhshealthquality.org.
Following publication of the NICE Interventional Procedure Guidance on Negative Pressure Wound Therapy (NPWT) for the open abdomen, a UK-wide audit has been commissioned by NICE to investigate the occurrence of intestinal fistulae with and without NPWT. The Health Services Research & Effectiveness Unit is facilitating NHSScotland’s participation in this audit, the results of which will be used to inform future NICE guidance (http://guidance.nice.org.uk/IPG322).
Click here to contact NHS-QIS
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News from IQWIG, Germany
The Institute for Quality and Efficiency in Health Care (IQWiG) has started working on its first commissions for evaluating the relation between cost and benefit. One project concerns 4 drugs for treating depression (venlafaxine, duloxetine, bupropion and mirtazapine). The other concerns clopidogrel for acute coronary syndrome and peripheral artery occlusive disease. IQWiG has already assessed the benefit of these drugs.
The health economic evaluation of drugs is a new procedure for Germany. It was introduced in the most recent health reform in 2007 and its purpose is to fix maximum reimbursable prices for specific new drugs. Prior to that, the assessment of drugs was restricted to medical benefit.
The prerequisite for fixing the maximum reimbursable price is that an alternative drug exists and that an additional benefit is shown. Up till now, there have been no price regulation instruments for new drugs in Germany. There will still be no fourth hurdle.
IQWiG will work according to the efficiency frontier method, which it developed with the support of a group of international health economists after the introduction of the health reform and which was published in October 2009. In line with legislation, this method ensures that medically necessary interventions will not be withheld from patients for financial reasons.
The 'analysis of the efficiency frontier' is the most suitable method for the German system. During the various submission of comments procedures, no better alternative proposal was put forward by any of the participants. Contrary to what some critics maintain, IQWiG is not following a different course from other countries. While the procedure is quite different to that in the UK, there are a lot of similarities with Australia. The first preliminary report is expected by autumn 2010.
For further information on the 'analysis of the efficiency frontier' method, please see: http://www.iqwig.de/index.736.en.html
Click here to contact IQWIG
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News from IHE, Canada
Fetal Alcohol Syndrome a Focus of the IHE in Canada
The Institute of Health Economics’ (IHE) Health Technology Assessment (HTA) Program continues the work in the field of Fetal Alcohol Spectrum Disorder (FASD).
The systematic review on prevention strategies for FASD is in the final stages of production and will be published soon. Two additional FASD projects have started recently: an overview of reviews of the evidence on best practices for prevention, diagnosis and treatment of FASD and a structured review of clinical practice guidelines for prevention, diagnosis and treatment of FASD. Results of these reviews are expected to help inform clinical and policy decisions.
The Consensus Development Conference on FASD - Across the Lifespan held in Edmonton, Canada in October 2009, was finalized with a consensus statement. The conference transcripts are due for publication in an IHE report. A book by Wiley: Fetal Alcohol Spectrum Disorders: A Policy Perspective that will provide governments with useful information for improved policies in the field of FASD is also on the list of upcoming publications.
Other IHE recent initiatives
The Alberta Ambassador Program constituted in 2004 and managed by the HTA Program recently started to create a guideline on the primary care management of headaches. The purpose of the guideline is to provide primary care practitioners who assess and manage Albertans with headache disorders with the best research evidence on the most effective and efficient treatments for this condition. The process involves the adaptation and contextualization of good quality international guidelines to the provincial healthcare system. Experts from across the province responded to this initiative and are participating in the development of the guideline.
The publication of the IHE book series by Wiley continues with a new handbook (Wiley-VCH) entitled Parkinson Disease: A Health Policy Perspective. This book was recently published and was written for a broad audience, health policy makers and other stakeholders interested in the Parkinson disease - correct diagnosis and early interventions - such as affected people, family members and other caregivers, health care professionals, and community health and social services providers.
Please check the IHE website for updated activities and events: www.ihe.ca.
Click here to contact IHE
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News from HIQA, Ireland 
2010 has been a very busy year for Ireland’s Health Information and Quality Authority (“the Authority”) so far. In January the HTA Directorate published its second HTA, a HTA of a population-based colorectal cancer screening programme, along with a Report on the use of resources in the national population-based cancer screening programmes and associated services.
Together these publications have made a significant impact in influencing the Minister for Health and Children’s decision to implement colorectal cancer screening in Ireland for 60-69 year olds from 2012. A decision was also announced by the Minister earlier this year to implement HPV vaccination in 12 year old girls. This decision was also significantly influenced by the Authority’s first HTA, a HTA of the role of human papillomavirus vaccines in reducing the risk of cervical cancer in Ireland. HTA is clearly beginning to shape health policy in Ireland.
2010 is going to get even busier as the Authority is now busy with preparations for hosting the 7th annual meeting of Health Technology Assessment International’s Society (HTAi) which is taking place in Dublin from June 6th to 9th 2010. The theme of this year’s meeting is “Maximising the Value of HTA” and it will feature over 800 presentations. If you haven’t registered yet, please do! Early registration deadline is 30th April. Conference details are available at www.htai2010.org.
Click here to contact HIQA
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News from ASERNIP-S, Australia 
Two recent rapid reviews are now available on our website: ‘Robotic-assisted surgery for urological, cardiac and gynaecological procedures’ and ‘Fast-track surgery and enhance recovery after surgery (ERAS) programs’. Both these reports include the results of semi-structured interviews of surgeons and other stakeholders, and provide a relatively comprehensive overview of the current state of both approaches to surgery.
An Evidence Essential of radiofrequency ablation for renal cancer has also recently been published. Although there was a small number of high level evidence on this topic, most of the evidence base was case series data. A comprehensive and up-to-date systematic review, which addresses safety issues in detail, would be valuable on this topic.
Over the past few months we have continued our involvement with the Health Technology Assessment International (HTAi) subgroup on patient/public participation. At the HTAi conference in June 2009 we forged a collaborative relationship with the HTA office of the Malaysian Department of Health. An ASERNIP-S staff member visited the department and delivered a 3-day workshop on the preparation of consumer information for policy makers and patients. Six draft consumer summaries were prepared by participants on issues of importance to the local health system.
The Australian Government, through the Department of Health and Ageing, and the Department of Finance and Deregulation have published a report of the review of health technology assessment in Australia. The report recommends a streamlining and rationalisation of assessments across the health system. This will attempt to reduce the burden on business and reduce process duplication and unwarranted costs. We will wait to see how these proposals affect our work as assessors in this process!
Click here to contact ASERNIP-S
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News from MaHTAs, Malaysia
MaHTAS continued to actively conduct health technology assessment for new health technologies. We had diversified our reports to meet the policy maker’s needs by introducing Information Briefs which are more concise and conducted faster than rapid reviews. In 2009, we produced three Health Technology Assessment Reports, 28 Technology Review Reports (rapid reviews) and 12 Information Briefs.
To further improve the quality of our reports, we had also included external review process for our Technology Review Reports recently. MaHTAS continued to provide training in Evidence Based Medicine, Health Technology Assessment and Systematic reviews for development of Clinical Practice Guidelines for Ministry of Health Staff. We had conducted three training sessions in order to improve awareness, to increase knowledge and to increase utilization of our health technology assessment reports. We had also conducted a consumer summary writing course with the involvement of Mrs Eleanor Ahern from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S).Three of our staffs had also participated in the poster, oral and plenary sessions in the 6th HTAi Annual Meeting held in Singapore.
We are also actively getting feedback from requestors and relevant personnel on the quality, uptake of recommendations and usefulness of our reports. Our reports are accessible from our Ministry of Health website at http://www.moh.gov.my.
Click here to contact MaHTAs
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News from ICTAHC, Israel
In preparation for the annual process of updating the National List of Health Services, the Medical Technology Policy Division at the Ministry of Health in Israel conducted a workshop on palliative treatment policy. Broadly scoped discussions focused on the responsibility of different health sectors such as: physicians, psychologists, social workers, physiotherapists etc. Dilemmas raised included who is responsible for palliative care, the integration of the community in determining health policy regarding palliative care, patient and family involvement in palliative care.
Palliative care borders on sensitive stages of health care linking curative and rehabilitative medicine. It is not only an end-of-life perspective but accompanies the passage of pain. Laws pertaining to patient rights should encompass palliative care and it is essential that palliative healthcare providers be recruited and appropriately trained.
Click here to contact ICTAHC
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News from Osteba , Spain
Osteba (the Basque Office for Health Technology Assessment) has developed the first Guideline for Not Funding existing health Technologies (GuNFT). The GuNFT guideline, presented in Bilbao last year, has been developed in order to enable and guide the process of assessment of certain health technologies that are candidates for disinvestment.
Currently, an implementation plan is being developed in order to test the applicability of the process in real life. Moreover, in the last months a software has been also developed in order to speed up and facilitate the information flow among those who wish to consider disinvestment in existing technologies: the technology assessing committee or organization and the management team or the decision maker who would take the final decision about the proposal. This software is going to be available in Basque, Spanish and English for free at the osteba website
http://www.osanet.euskadi.net/r85-osteba/es/contenidos/informacion/osteba/es_osteba/osteba.html.
The barriers identified in the implementation process would help us to improve the guideline and the related software, contributing in this way to structure the global process.
Click here to contact Osteba
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News from UETS , Spain
The UETS (Spain) HTA Agency has developed three new HTA reports. Effectiveness of the surgery with the Da Vinci Surgical System, being used in different surgical settings such as urology, general surgery, gynecology and cardiothoracic surgery. A systematic review of Ultrasonography in Breast Pathology and a report on Orthomolecular Therapy for Autism treatment. (HTA reports available in http://www.madrid.org/lainentralgo)
UETS Unit has also been working in three Clinical Practice Guideline for Primary Care (CPG) in Spain, involving patients in the development process: CPG on the Management of Patients with Autistic Spectrum Disorders (ASD); CPG for Management of Patients with Stroke in Primary Care, and CPG of Management of Patients with insomnia in Primary Care (GPGs available in http://www.guiasalud.es/egpc/index.html). A national conference has been schedule for April 29th in our Agency for the CPG presentation: Autistic Spectrum Disorders meeting. Launch of a Clinical Practice Guideline.
Click here to contact UETS
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News from HSAC , New Zealand
Recent publications
These publications can be viewed or downloaded from HSACs’ website: http://www.healthsac.net/publications/publications.php
Problematic substance use in older adults: a rapid literature scan
The purpose of this project was to identify practical resources for service providers in New Zealand working with older adults in residential aged care with historical or current substance use problems.
How to increase the delivery of effective smoking cessation treatments in primary care settings: Guidance for doctors, nurses, other health professionals & healthcare organisations: summary report
This report summarises the evidence on the delivery of effective smoking cessation. It focuses on the ABC approach to smoking cessation which brings with it a more “assertive” manner in which clinicians can work.
Representation at International Meetings
Drs Adele Weston, Sarah Norris and Kristina Coleman attended the ISPOR Europe conference in Paris, in October 2009. Dr Ray Kirk will represent HSAC at The Health Policy Advisory Committee on Technology (HealthPACT) Australia and New Zealand Horizon Scanning Network Meeting, in Melbourne, Australia, on 8 April 2010.
Panel of providers for the National Health and Medical Research Council (NHMRC)
HSAC has been selected to join the panel to provide expertise to assist NHMRC with the development of evidence based health advice.
Click here to contact HSAC
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News from DAHTA at DIMDI, Germany
Since November 2009 six new HTA-reports have been published. The topics are as follows:
- Efficacy and efficiency of the prevention and screening for Methicillin-resistant Staphylococcus aureus in Germany
- Nonmedicinal secondary prevention of patients with coronary heart disease
- Efficacy and cost-effectiveness of the 13C-urea breath test as the primary diagnostic investigation for the detection of Helicobacter pylori infection compared to invasive and non-invasive diagnostic tests
- New-onset diabetes and antihypertensive treatment
- Specific Immunotherapy (SIT) in the treatment of allergic rhinitis
- Methods for assessment of innovative medical technologies during early stages of development
The abstract and the summary of each report are in English. The whole report is in German language. All versions are available in the DAHTA-database as well as in the open access journal German Medical Science HTA (gms).
Besides, especially the process of topic finding and the impact analyses form the current challenges. DAHTA is supported in its work by two boards: the Board of Trustees and the Scientific Advisory Board. The HTA-process of DAHTA is continously evaluated.
DAHTA has increased its participation in activities outside of the institute and constantly attends national and international events, conferences and congresses (e. g. EUnetHTA). As a member of EUnetHTA DAHTA participates especially in Work Package 4 (WP4) concerning the Core HTA model. The next milestone in WP4 will be to apply the Core HTA model to two topics in the areas of diagnosis and intervention.
Links
- DAHTA: http://www.dimdi.de - HTA
- GMS Health Technology Assessment: http://www.e-gms.de/dynamic/en/journals/hta/index.htm
- Scientific journal series of the Health Technology Assessment (HTA) in the Federal Republic of Germany: http://www.e-gms.de/static/en/reports/dahta/index.htm
Click here to contact DAHTA
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News from SBU, Sweden 
SBU is currently working on following topics:
Diagnosis and treatment of ADHD and autism spectrum disorders
Diagnosis and treatment of psychosis and schizophrenia
Diagnosis of mood disorders
You can find the list with on-going projects at: http://www.sbu.se/en/Ongoing-projects/
In addition, following reports have been published:
How Can Drug Consumption among the Elderly be Improved?
Laser Technology for Removal of Caries
Silver dressings to treat chronic wounds
The complete list with published reports can be viewed at: http://www.sbu.se/en/Published/
Click here to contact SBU
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RSS feed with News from INAHTA members
A section for RSS feed for "News from INAHTA members" has been developed on the Members-Only section.
Click here to view the RSS feed with News from other HTA agencies.
Please contact the Secretariat if you would like to make public the RSS feed function from your agency.
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Please contact the Secretariat if you would like to comment on previous announcements or publish a new one in the Members-Only update.
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