Ultra-rapid HTAs: a survey of usefulness and influence in decision making

Article type
Year
Authors
Rey-Ares L1, Bardach A2, Ciapponi A2, Tapia-López E1, Alcaraz A2, Pichon-Riviere A1, Augustovski F1, García-Martí S2
1Institute for Clinical Effectiveness and Health Policy (IECS), Argentina
2Argentine Cochrane Center, Institute for Clinical Effectiveness and Health Policy (IECS), Argentina
Abstract
Background: IECS is a Health Technology Assessment (HTA) agency in Latin America, that provides reports to public institutions, social security and private insurance entities. Since 2012 we have produced ultra-rapid reports, completed within 72 hours, aiming to solve specific coverage problems, often related to a single patient needs. Decision-makers systematically complete a brief survey on usefulness and satisfaction within two weeks of receiving the report.

Objectives: To evaluate the usefulness for the decision makers and the influence of ultra-rapid, patient-based HTA reports in the decision-making process, as well as their agreement with final coverage decisions.

Methods: Descriptive and analytic cross-sectional study. We analysed the survey responses and compared the agreement between the final coverage decision and the conclusions of the report. The Ultra-rapid HTAs do not make recommendations about coverage, but provide information about efficacy and safety to help decision-making.

Results: From May 2014 to February 2016 we collected a total of 68 responses from 117 reports (58%). In only 10.3% of the cases the decision was still pending at the time of the survey; 47.1% had a coverage denial and 42.6% a positive coverage. All seven cases with no decision made yet had a negative conclusion in the report. In case of active decisions, the crude agreement rate was high (76.5%) (Fig 1).
Regarding usefulness: 96% of decision makers found the report useful or very useful; 85% stated that the report had influenced their decision; 90% thought the quality of the decision-making improved with the reports and inputs were better after reading the report; and 99% were satisfied with the service (Figure 2).
The three most frequent consultations were related to cancer, neurological and musculoskeletal disorders; and half of the cases were related to drugs.

Conclusions: Most decision makers found ultra-rapid HTA reports useful and reported that their final decisions were influenced by them. Agreement with final decisions was high.