By NextBestFitPhase 1: Enactment & build · Step 1.10
Create the Health Technology Assessment Institute
Months 0–18; continuous · HTA Institute (independent, within HHS)Discuss this step
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | An independent body that evaluates whether new services, devices, and drugs work better than existing alternatives, and recommends coverage and price. Removes ineffective services from the benefit package. | ||
| United Kingdom | NICE (1999) issues technology appraisals and clinical guidelines. | Global model for HTA; criticized over QALY thresholds. | An independent body depoliticizes coverage decisions, partly. |
| Germany | IQWiG assesses benefit; G-BA decides coverage. | Separates evidence assessment from the decision. | Separating assessment from appraisal improves legitimacy. |
| Australia | PBAC and MSAC advise on drug and service listing with cost-effectiveness. | Strong value discipline. | HTA works for services as well as drugs. |
United Kingdom
- What they did
- NICE (1999) issues technology appraisals and clinical guidelines.
- What happened
- Global model for HTA; criticized over QALY thresholds.
- Lesson for this plan
- An independent body depoliticizes coverage decisions, partly.
Germany
- What they did
- IQWiG assesses benefit; G-BA decides coverage.
- What happened
- Separates evidence assessment from the decision.
- Lesson for this plan
- Separating assessment from appraisal improves legitimacy.
Australia
- What they did
- PBAC and MSAC advise on drug and service listing with cost-effectiveness.
- What happened
- Strong value discipline.
- Lesson for this plan
- HTA works for services as well as drugs.
More precedent
- NICE (UK, 1999); IQWiG (Germany, 2004); CADTH (Canada); HAS (France).