"Given the constant evolution of new and more expensive treatments and diagnostics, the developing world faces the risk of a continuous and growing inequity whereby a few will continue to access costly technologies of marginal benefit while most don’t even have access to basic and highly cost-effective care. We aim to contribute to the achievement of more equitable and effective health systems through the promotion of an increased use of Health Technology Assessment in policy making."
History and Structure
The Institute for Clinical Effectiveness and Health Policy (IECS) is an independent, non-for-profit organization devoted to research, education and technical support. IECS’s President is Prof. Adolfo Rubinstein and the Health Technology Assessment and Economic Evaluation Area is directed by Prof. Andres Pichon-Riviere and Prof. Federico Augustovski.
Over the last few years, IECS has been a leading institution in Latin America (LA) in regards to developing HTA reports and economic evaluations (EE) to study the impact and financial implications of the adoption of technologies on health care systems. IECS HTA unit is focused on the analysis of clinical, economic and social impact resulting from the use of drugs, devices, practices and health care services. This unit is composed of 12 investigators including epidemiologists, health economists, social scientists, biostatisticians, and a librarian, who produce more than 30 HTA reports (HTAr) and EE per year. These documents, assessing the effectiveness, safety, costs and cost-effectiveness of interventions and technologies, are intended to inform policy makers, health professionals, patients and users, on resource-allocation decisions concerning health care coverage and policies.
IECS coordinates academic and research projects (HTA and multi-country economic evaluations) with MoHs and research institutions in Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru and Uruguay.
Available training activities at IECS include a Master Program in Clinical Effectiveness from the University of Buenos Aires and an annual course in HTA and Economic Evaluations (basic and advance modeling). With the support of a grant from the Global Health Research Initiative from Canada (CIDA, CIHR and IDRC), and the support from the Pan American Health Organization (PAHO) and INAHTA, IECS has developed the first HTA e-learning course in Spanish and Portuguese aimed at Latin-American researchers and decision makers.
To improve efficiency, equity, quality, and sustainability of healthcare systems and policies.
How IECS works
Our publications are subject to an internal peer review process and to an external process in the case of peer-reviewed journal article submissions or scientific meeting presentations.
In producing HTA documents, a research question is assigned to each of our lead researchers. To review the process, a weekly meeting is held with the full team and the two responsible for HTA at IECS. Teams are composed of a junior and a senior researcher. Each document is peer reviewed by the HTA committee composed of the two directors and two senior researchers. For many of our internal documents, we involve external experts in the peer review process and feedback.
HTA documents are classified based on depth and comprehensiveness, as follows:
- Full HTA Documents include a complete evaluation of a technology, considering its efficacy, effectiveness, security, cost effectiveness, and impact on the local health system. The reports are based on systematic literature searches and classification and synthesis of the evidence.
- Rapid Response Reports constitute a rapid response to an information request. The literature search focuses mainly on secondary sources (eg, HTA documents by other agencies, systematic reviews, meta-analyses, clinical guidelines, health coverage policies) and the original primary research studies. These are not necessarily exhaustive systematic reviews on the subject, systematic searches of primary studies, or our own elaboration or analysis of data.
- Brief Technical Reports are preliminary evaluations of a particular health technology, focusing mainly on efficacy, effectiveness, and safety. They are based on literature searches, classification, and synthesis of evidence and are not necessarily our own elaboration of data or analysis of local data. The information could serve as a preliminary evaluation for a full HTA Document.
IECS publications are available in electronic and printed formats. Abstracts from all the HTA reports (in English and Spanish) may be accessed from the IECS’ website and are indexed in the United Kingdom Health System Centre for Reviews and Dissemination (CRD) hosted by The University of York. IECS’ website receives nearly 10,000 visits each month and the HTA reports are also disseminated through a monthly HTA e-newsletter aimed to a network of 5,000 registered users (decision makers and researchers from more than 20 countries).
Current Projects (A Selection)
- Etanercept, infliximab, efalizumab, adalimumab for psoriasis treatment
- Intensity modulated radiotherapy (IMRT) for prostate cancer
- Usefulness of videonistagmography
- Cost effectiveness of conjugated anti-pneumococcal vaccines in Latin American Countries
- Hepatitis C antigen detection in the diagnosis of Hepatits
- Usefulness of procalcitonin in lung infection
- Low back pain treatment using radiofrequency techniques
- Cost effectiveness of HPV vaccine in Latin American Countries
- Cost effectiveness of smoking cessation treatment coverage policies in Latin America
- Sectoral cost effectiveness analysis of a package of interventions to reduce cardiovascular disease in the public sector of Buenos Aires, Argentina
- Developing a healthcare cost database for HTA and economic evaluation in Argentina
We are developing informational material for health system users (individuals and patients) to expand the resource allocation decision making process and health coverage policies to different stakeholders.
Description of population served: National, focused on MoH, health secretariats of many provinces and districts, superintendents of Social Security, Social Security Funds, private insurers, etc.
Population served (mil): 36
Current HTA budget (mil USD): 0.450
Permanent staff: 12
Ongoing TA projects: 15
Director: Prof. Dr. Andres Pichon-Riviere
Contact person: Sebastian Marti-Garcia
Institute for Clinical Effectiveness and Health Policy
Viamonte 2146 – 3 Piso
C1056ABH Ciudad de Buenos Aires Argentina