Decision-making in the health technology assessment system: basic approaches, criteria, and conditions

The development of the health technology assessment in Ukraine involves not only its wider implementation in medical and pharmaceutical practice, but also the mandatory use of its results to substantiate decisions on the rational use of medicines and cost optimization. Aim. To study the peculiarities of organizing expert and advisory processes in the system of the health technology assessment, in particular, methodological approaches, criteria, and conditions for decision-making based on it. Materials and methods. Using a systematic approach, the analysis, generalization and systematization of data from scientific publications, analytical and reporting documents were carried out. A survey of medical and pharmaceutical workers was conducted on the use of results of the health technology assessment in practical activities. Results and discussion. The analysis shows significant differences in the organization of the health technology assessment and critical evaluation of its results (appraisal) for decision-making based on it. A survey of physicians and pharmacists revealed the main approaches, criteria, and conditions for evidence-based decision-making and their information support. The survey results indicate the insufficient use of the health technology assessment results in practice due to lack of time, inaccessibility of resources, and the absence of relevant knowledge and skills. Respondents are guided primarily by regulatory documents (protocols, guidelines, forms), relying on their own experience and the expert opinion. At the same time, specialists are aware of the importance of assessment for selecting optimal health technologies and improving the efficiency of medical and pharmaceutical care. Conclusions. The development of theoretical and methodological approaches to the organization of expert and advisory processes, the involvement of stakeholders, the use of information sources, analytical tools for their critical assessment, and processing tools is an important step in the implementation of the health technology assessment at various levels of management.