Mapping of Health Technology Assessment in China: A Comparative Study Between 2016 and 2021

Abstract

Abstract Background Health technology assessment (HTA) in China has recently expanded from pure academic research to include policy or decision-oriented practice, especially after the use of HTA evidence to update the National Reimbursement Drug List for the first time in 2017. This study aimed to identify the progress and challenges of HTA development from 2016 to 2021 and to inform policies and decisions to promote further development of HTA in China. Methods We conducted a cross-sectional web-based survey to policy maker, researcher and industry-provider in China in 2016 and 2021 respectively. The mapping of HTA instrument was used to reflect the HTA development from eight domains: institutionalization, identification, priority setting, assessment, appraisal, reporting, dissemination of findings and conclusions, implementation in policy and practice. To reduce the influence of confounders and to compare the mapping outcomes between 2016 and 2021 group, we performed a 1:1 propensity score matching methodology in this study. Univariate analysis was performed to compare the differences in these two groups. We also compared the overall results with that of a mapping study that included ten countries. Results A total of 212 and 255 respondents completed the survey in 2016 and 2021 respectively. After propensity score matching methodology, 183 cases from the 2016 group and 2021 group were matched. Overall, the mean score of 2021 in most of the domains was higher than 2016 in China (P < 0.05), such as the level of HTA institutionalization, appraisal and dissemination strategy, except for assessment. Although China scored significantly lower among the three developed countries, the overall HTA development score was comparable among the ten countries. Conclusions Our study suggested the level of HTA development in China has achieved significant progress from 2016 to 2021. Prior to HTA activities, more efforts should be made to the assessment process, for example, describing a clearer goal and scope of HTA, adapting standard HTA methodologies for assessing the performance of systematic review or meta-analysis, providing a clear description of the safety and clinical effectiveness, cost and cost-effectiveness of the technology in their assessments, et al, thus improving the development of HTA in China.