Establish a Regional Health Technology Assessment Institution to Improve the Comparative Effectiveness of Interventions for NCDs and other Conditions
First, the volume of new research makes it difficult for any single entity to keep track of it all. It is not possible for institutions—and certainly not for individuals—to keep abreast of the nearly 100,000 new papers published in the health sciences literature every year (NLM 2009). The technical solution has been the emergence of specialized entities that conduct systematic literature reviews.
Some of these entities are academic centers and government agencies that either contract out or directly conduct these reviews; others are self-standing not-for-profit organizations, such as the Cochrane Collaboration,probably the best-known of these entities.
Second, many research studies use different approaches and methods, leaving the advantage of one treatment relative to another unclear. In an attempt to tackle this challenge, comparative effectiveness assessments of interventions and treatments examine the efficiency (the outcome yielded from the inputs) by examining two or more treatment options and deciding which has
(i) the greatest efficacy (the outcome in a carefully controlled study setting),
(ii) the greatest effectiveness (the outcome in a typical clinic or community setting),
(iii) the greatest cost-effectiveness (the cost per outcome achieved). Countries may use different assessment methods and acceptability thresholds that are not necessarily standard and would fit other countries objectives.
Comparative effectiveness is also used to improve allocative efficiency (targeting resources where they will be the most effective and likely have the largest impact). Many countries have a legacy of heavy investment in hospitals and much less investment in ambulatory services where highly cost-effective interventions can be delivered (Chapter 2). This is true in some South Asian countries.
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