Technical Assistance for the Development of Health Technology Assessment in the Philippines

Overview

The Philippine HTA system was created in 2019 with plans to begin reassessments of existing health packages by the year 2020. Unfortunately, these were severely delayed by the onset of the COVID-19 pandemic, which began in March 2020. As a result, the HTA was refocused to assessments related to the treatment and management of COVID-19. Since then, there have been several completed expedited reviews for COVID-19 vaccines, drugs, tests, and devices. Aside from the COVID-19 related assessments, the Philippine HTA team has also completed the reassessment for pneumococcal vaccines (PCV-13) and published the first versions of their process and methods guides.

This study was divided into 3 different parts, with each part looking at different aspects of the HTA in preparation for a post-pandemic implementation. The first part aimed to review the existing HTA processes and its implementation to identify gaps, strengths, and weaknesses. It also had the objective to address the identified problems through benchmarking with established international HTA processes and literature review.

With the passing of the Universal Health Care Act into Law, the HTA was identified as a crucial component to its success. Thus, setting up the HTAC would need a clear roadmap, especially with the UHC Law and the context of the pandemic. The second part of the study was focused on creating a roadmap in setting up the HTAC through identifying the current and future preferred status for the next 10 years.

The third and final part focused on the role of the HTA Unit. With the institutionalization of the HTA back in 2019, it set a transition after 5 years for it to be under the Department of Science and Technology to establish itself as an independent entity from the DOH. Using the UNDP INNE framework, this part of the study aimed to identify the existing capacity of the HTAU in its function to support the HTAC and create recommendations for the necessary staff and transition to its new place in the DOST. It also created an internal assessment of the staff to properly outline and plan the staff needed in the unit.

Methods

Most parts of the study implemented a mixed method approach, combining surveys, interviews and focused group discussions with the necessary stakeholders, and a literature/document review. The first part also applied an abbreviated consultation and brainstorming which was inspired by Design Thinking Framework and tools from Business Process Improvement. For the roadmap creation, the roadmap conception with HTAC members was created through a roadmap scorecard that was developed by Kalo, et al. Finally, the final part applied a survey adopted from the European Network for Health Technology Assessment to generate the internal capacity assessment. Combined with the results of the first 2 parts, another brainstorming session was held to map out the gaps vis a vis the current positions in the HTAU.

Summary of Recommendations

As with many organizations, Philippine HTA is working with limited resources. Adding to the challenge was the unexpected demand for assessments brought about by the COVID-19 pandemic. Optimizing the resources available and strategic planning for the medium and long term will enable HTA to progress and grow. Various solutions were conceptualized in the first part of the project, ranging from proper Crisis Management Training, creating protocols for the so-called New Normal, and a Data Inventory to address gaps, quality and enforce proper M&E. The second part of the study showed that the council should retain the policies on the scope of HTA. Aside from this, to ensure smoother processes, the role of HTAU should have enough technical and secretarial support. The council should also play a more active role in establishing and maintaining international collaborations. Overall, institutionalizing these processes will build stronger collaborations.

Diverse networks must be engaged to improve the research capacity and engage the public in consultation, feedback, and utilization of results. These, together with strong political will and proper policy alignment, will create a supportive environment for HTA. The HTA involves multiple stakeholders at different parts of the entire process that are diverse but interdependent on each other. Thus, capacity building should be holistic, and consider all relevant stakeholders from the individual, organization, network, and environment levels.