Health Technology Assessment for Policy Making in India: Current Scenario and Way Forward

The Indian government has made a commitment to achieve Universal Health Coverage (UHC) [1, 2], as a means to reduce catastrophic out-of-pocket health expenditure and ensure affordable access to essential health care for the entire population. As part of the plan to deliver UHC, the government has identified ensuring value for money in the health budget to be a key priority [1, 2]. The central government has outlined a plan to devolve a greater share of the overall tax base to states, who in turn will become more important players in financing health care programmes [6, 7]. This implies that states will be making resource allocation decisions on what to provide, to whom, and how much. Simultaneously, the central government is increasingly adopting the role of strategic purchaser of health care [3–5]. These ongoing developments require a systematic process for generating policy-relevant evidence that can inform policy decisions regarding health resource allocation, i.e. clinical effectiveness studies, cost-effectiveness studies, budget impact studies, as well as ethical, social and political feasibility studies. This systematic and comprehensive process falls under the broad umbrella of health technology assessment (HTA) [8]. HTA is the international gold standard for utilizing health economic principles to comparatively assess evidence for cost, clinical effectiveness, safety, and equity to provide evidence as to whether an intervention is a cost-effective investment within a given health system and to assist in the prioritization of health resources. The Government of India’s Department of Health Research (DHR), part of the Ministry of Health and Family Welfare (MoHFW), is currently in the process of establishing a medical technology assessment board (MTAB), which will be the central agency for undertaking HTA in India [9]. The MTAB will operate through a three-tier structure, with the secretariat at its base, a technical appraisal committee (TAC) in the middle, and the MTAB at its apex. The name of the recommendatory body is based on its apex tier. The central coordination of activities and development of the HTA processes and methods will be managed by the MTAB secretariat based within the DHR. The TAC will be made up of technical experts drawn from a range of institutes around the country with expertise in a variety of relevant disciplines. The TAC will have the role of prioritizing the topics for which to conduct HTA, quality assuring the analyses produced as part of the HTA, and engaging with and incorporating the views of the various stakeholders relevant to the HTA. A number of technical partners (TPs) will be engaged to conduct the various analyses underpinning the HTAs. The TPs are institutions that have been identified by the DHR as having the capacity to undertake the relevant analyses. The final analyses will be submitted, once quality assured by the TAC, to the MTAB to deliberate on and make recommendations to the Minister of Health and Family Welfare. The MTAB will comprise a wide range of multi-representative members from public, private, academic, and civil society groups. & Shankar Prinja shankarprinja@gmail.com