Presentaci

1

• CENETEC
• Three years experience of a health technology
  assessment unit in Mexico
• Rosa María Ceballos
• March, 2008

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Contents

• Introduction
• Challenges
• Strategies
• To improve HTA production
• To increase the use of HTA
• To foment collaboration
• To disseminate results
• Conclusions

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Contents

• Introduction
• Challenges
• Strategies
• To improve HTA production
• To increase the use of HTA
• To foment collaboration
• To disseminate results
• Conclusions

4
103 million inhabitants 2 million KM2 74 Urban
population 24 million people in towns less than
2,500 ih
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Segmented health services
Ministry of Health and 32 states
C
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Mexican Health Care System Structure, financing
and coverage
Structure
Social Security
Popular Insurance
Private Sector
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Ruelas E. HTA and Governance in the Americas.
Lecture in the HTAi Meeting, Montrel 2008
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Health Technology Purchasing Decision Making
Process
General Health Council
Basic Chart
Private Sector Decision free of
restrictions (2 analyze, evaluate)
Other Gov.
Ministry of Health
COFEPRIS
IMSS
Federal level
CENETEC
Registry
Drug Equipment list
Technology Assessment Unit
National Health Council
Estate level
Health Technology Purchasing
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Ruelas E. HTA and Governance in the Americas.
Lecture in the HTAi Meeting, Montrel 2008
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CENETEC
MEDICAL EQUIPMENT PLANNING
HEALTH TECHNOLOGY ASSESSMENT
eHEALTH AND TELEMEDICINE
Telemedicine guidelines Teleconsultation
guidelines Operation E health web site
Certificate of need HTA reports Clinical
Practice Guidelines Patient information
Technology guidelines Models for hospital
equipment Clinical Engineering Master Medical
Equipment Plan
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Challenges

• Increase HTA production
• Scientific credibilityof producers
• Standardize assessment methods
• Increase the use of HTA among decision makers
• In priority setting
• HT incorporation

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Barriers

• Ned for multidisciplinary team
• Pressure from caregivers
• Pressure from vendors and consumers
• Inertia
• Explicit priority setting is difficult to sell,
  similar to rationing
• Corruption

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Facilitators

• Decision makers trust CENETECs products for
  medical equipment planning.
• Legal support documents
• National Health Program 2007-2012
• Main objective to increase safety, accesibility,
  quality and safety in HC.
• 4.3 To set priorities among interventions based
  on a process of assessment of clinical,
  economical, social and ethical
• 4.5 To promote HTA
• Political support!

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• The poorest the country, the more the efforts
  towards HTA.
• Enrique Ruelas B.
• Secretario del Consejo de Saludbridad General
• HTA and Governance in the Americas.
• Lecture in the HTAi Meeting, Montrel 2008

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Contents

• Introduction
• Challenges
• Strategies
• To improve HTA production
• To increase the use of HTA
• To foment collaboration
• To disseminate results
• Conclusions

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Increase the use of HTA

• Becoming advisors for the General Health Council
  in HT incorporation to the Basic Chart
• Providing information for the Drug Price
  Negociating commision
• Legal support
• Modification of CENETECs legal attributions
• National Health Program 2007-2012
• WHA 60

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WHA60.29 Resolution

• Approved on may 23rd, 2007.
• Urges the member states
• Collect Information of medical devices,
  prioritization needs, resources allocation.
• National strategies for assessment, planning,
  procurement and managment of HT
• National guidelines for GMP, quality,safety and
  efficacy, and
• International harmonization
• Establish national institutes for HT

http//www.who.int/gb/e/e_wha60.html
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Cenetecs products ...

• Certificate of need
• High cost Medical Equipment
• Needs assessment Clinical need
• Similar equipment in the area, productivity and
  availability
• Specialized personnel available
• Acquisition alternatives
• Cost-benefit analysis

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... Cenetecs products

• HTA
• Clinical, economical, social and ethical
  implications
• Full report
• Evidence informed recommendations
• One or two dimensions
• 5 year search
• Published studies only
• Simplified report

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CENETECs products
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Improving HTA production

• Generate consensus over methodology
• Economic evaluation methods document from General
  Health Council
• Networking
• Identification of key producers
• First HTA network meeting
• Training
• Introductory course to HTA
• Specific courses planned

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Results dissemination

• Gaceta CENETEC
• HTA section in CENETECs webpage
• Proposed website for HTA network
• Anual HTA workshop

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Contents

• Introduction
• Challenges
• Strategies
• To improve HTA production
• To increase the use of HTA
• To foment collaboration
• To disseminate results
• Conclusions

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HTA in México

• Working on production and use
• Consider all Healtcare providers
• Credibility of producers
• Provide legal foundations to work
• Reform when necessary
• Networking
• Standardization
• Training
• Beleiving that what we do will help provide
  better health care for all mexicans!
• striving.not giving up!

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Gracias!

• rceballos_at_salud.gob.mx
• Centro Nacional de Excelencia Tecnológica en
  Salud
• 5255 5208 3939
• www.cenetec.gob.mx