Dáil Éireann Debate, Wednesday - 18 May 2022
200. Deputy Pádraig O'Sullivan asked the Minister for Health the governance processes for health technology assessments; the extent to which external oversight is a feature of the health technology assessment process; the planned publication date of a report (details supplied); and if he will make a statement on the matter. [25083/22]
View answerHealth technology assessment (HTA) is a multidisciplinary process that summarises information about the medical, social, economic, and ethical issues related to the use of a health technology. Examples of health technologies include medicinal products, medical equipment, diagnostic and treatment methods, rehabilitation, and prevention methods. Its aim is to inform the formulation of safe and effective health policies, investment and reimbursement decisions that are patient focused and seek to achieve best value.
The Health Information and Quality Authority (HIQA) and the National Centre for Pharmacoeconomics (NCPE) are the two agencies primarily responsible for the undertaking of HTA in Ireland.
HIQA conducts HTAs of health technologies to inform national health policy and national health service decisions at the request of the Minister for Health and the HSE. This is conducted in line with a prioritisation process. HIQA constitutes an expert advisory group (EAG) for each HTA with a multidisciplinary membership, including relevant clinical expertise and patient and public representation. The EAG provides input throughout the process and reviews the draft HTA report. Once developed the HTA work programme is approved by the Board of HIQA. Final HTA reports are submitted to the decision maker and published on the HIQA website.
The NCPE was established in 1998 and its remit is to advise the HSE and the Department of Health in relation to the cost-effectiveness of medicines, through the carrying out of HTAs. The Health (Pricing and Supply of Medical Goods) Act 2013 gives full statutory powers to the HSE to assess and make decisions on the reimbursement of all medicines. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the NCPE. The NCPE conducts HTAs for the HSE and makes recommendations on reimbursement to assist HSE decisions.
Following a tender by the Office of Government Procurement, Mazars conducted a review of the governance structures around the HSE's drug reimbursement process. The report was submitted to the Department in January 2020. The review made recommendations in respect of the HSE’s systems, structures, processes, governance arrangements and use of specialist resources in respect of the drug reimbursement process.
The report was under consideration by officials, however the focus of the Department of Health changed to the immediate public health considerations of the COVID-19 pandemic and the preservation of life. This meant that this work stream was suspended to reallocate resources to support essential services. The Department aims to complete its consideration of the report’s recommendations when resources permit.
