The Mini Course “Health Technology Assessment" was held on April 1-5, 2024 at at the Peking University Institute for Global Health and Development (GHD) . It was taught by Associate Professor Jin Huajie from the Department of Health Economics at King's College London. The course focused on health technology assessment (HTA), combining HTA theory and practice, systematically introducing the concept and basic methods of health technology assessment, as well as the operational process of HTA conducted by the UK’s National Institute for Health and Care Excellence (NICE). Professor Gordon G. Liu, the Dean of GHD and Boya Distinguished Professor at PKU’s National School of Development delivered a speech on behalf of the institute, expressing gratitude to Professor Jin for coming from the UK to teach at Peking University and welcoming participants to the course. Professor Liu emphasized the importance of HTA, expressing hope that the participants could take advantage of this opportunity.
The theme of the first day was "Introduction to Health Technology Assessment." Professor Jin first expressed gratitude to the participants for their attendance, briefly introduced the arrangement of the mini-course, classroom rules, and assessment methods, and encouraged all participants to actively engage in classroom discussions and presentations.
In the afternoon session, the participants engaged in systematic reviews and economic evaluation practice exercises through group discussions. Students from various universities such as Peking University and Tsinghua University, as well as participants from pharmaceutical companies, hospitals, and other institutions, actively participated in the course presentations and assignments. Professor Jin also patiently answered questions regarding research directions and technical aspects and engaged in extensive discussions.
The theme of the second day was "Methods of Health Technology Assessment and Artificial Intelligence." Professor Jin initiated the session by delineating the research and analytical methodologies employed in health economic evaluation. The objective is to optimize patient outcomes while minimizing opportunity costs through comparative assessments of costs and clinical benefits across various health technologies. Furthermore, Professor Jin deliberated on the merits and drawbacks associated with health economic analysis grounded in clinical trials, real-world data, and economic models.
Throughout the lecture, Professor Jin illustrated the integration of direct and indirect costs into health economic evaluations. Utilizing examples of schizophrenia and antipsychotic drugs, she elucidated the evaluation outcomes employing cost-effectiveness planes. Additionally, Professor Jin underscored the pivotal role of health economic evaluation in informing decision-making processes related to research and development, estimating the economic burdens of diseases, and establishing clinical guideline priorities.
In the afternoon session, Professor Jin introduced the application of artificial intelligence (AI) in health economics research. She first explained the potential of AI in health economics analysis. Through cases of remote cognitive correction trials and clinical trials of tuberculosis, she demonstrated how AI can assist in the design and data collection of health economics analysis. Professor Jin emphasized that AI can efficiently handle and analyze large amounts of medical data, thereby improving the accuracy and efficiency of research.
Of course, the application of AI in the field of health economics also faces challenges such as data permissions, privacy protection, transparency, and professional knowledge. Although AI technology is powerful, it is still a tool, and its security and effectiveness depend on the intentions and abilities of the users. As such, Professor Jin encouraged researchers to embrace technology while also practicing original and critical thinking to adapt to the AI era. After the lecture, Professor Jin assigned group assignments to the students, dividing them into 5 groups and requiring each group to prepare a closing presentation.
The theme of the third day was "Strategies for Systematic Reviews in Health Technology Assessment." Professor Jin elaborated on how to conduct systematic reviews for health economic evaluations and the key points to consider when designing search strategies.
She first explained the difference between traditional literature reviews and systematic reviews. Traditional literature reviews often lack detailed method descriptions, making them susceptible to the influence of authors' personal experiences and subjective judgments, which may lead to biases in research conclusions. In contrast, systematic reviews employ specific, clear, and replicable methods to comprehensively collect all relevant studies to derive more objective comprehensive conclusions. Professor Jin outlined the key steps in conducting systematic reviews, including searching for published reviews and protocols, formulating clear research questions, designing and adjusting search strategies, conducting two rounds of screening (titles and abstracts, full text), piloting data extraction, and using or adapting published tools. She suggested using the PRISMA checklist to ensure the transparency and completeness of the research.
Professor Jin also provided some practical examples of search strategies to help students better understand effective search strategies. Next, she shared methods for effectively designing search strategies, searching medical databases, and global health and region-specific databases, which are essential for conducting high-quality health economic evaluation research. Professor Jin also introduced the concept of grey literature, helping researchers control biases, find unpublished evidence, hear more diverse voices, and emphasize the issues of reliability, information quality, and durability.
Furthermore, through practical cases, Professor Jin demonstrated how to design search strategies for specific research questions and explained how to identify key concepts, add synonyms and alternative terms, use Boolean logic to connect concepts, and consider the importance of truncation, wildcard, and adjacency in search strategies. After the lecture, Professor Jin provided ample time for group discussions and patiently answered students' questions.
The theme of the fourth day was "The Experience of Health Technology Assessment in the United Kingdom." Economic evaluation plays a crucial role in medical decision-making. Professor Jin explained how NICE in the UK decides whether a certain medical intervention is worth recommending. She explained with examples that when ICER > £20,000 per QALY, the following factors need to be considered: 1) ICER certainty; 2) Whether there are sufficient reasons to indicate that the measurement methods of health outcomes do not fully capture the changes in patients' quality of life, and fail to fully reflect the health benefits brought by health technology to patients 3) Whether the health technology is a significant innovation, whether it has substantial benefits that can be confirmed and unique, and whether it has been fully reflected by existing health outcomes. If the treatment's ICER exceeds £30,000 per QALY, it is necessary to carefully evaluate whether the use of the treatment can effectively utilize the resources of the National Health Service (NHS), continue to refer to the above three factors, and provide more evidence.
Through Professor Jin's course, students learned that the cost-effectiveness of health technology is the main factor influencing most NICE decisions. As ICER increases, the probability of NICE rejecting certain health technologies also increases. Finally, Professor Jin introduced the key factors and cases influencing NICE decisions, clarifying the decision-making process and providing references for medical decision-making.
The theme of the last day was "International Practices and Trends in Health Technology Analysis." Professor Jin introduced the challenges and future development trends faced by HTA in China and other countries. By studying the "Key Issues in Health Economic Analysis of China HTA," she introduced three key issues in health technology assessment: 1) Setting cost-effectiveness thresholds: how much the medical insurance should pay to gain an additional quality-adjusted life year (QALY); 2) Calculating the price of drugs for multiple indications: whether to set one price for one drug or one price for one indication; 3) Selection of reference drugs.
Professor Jin also invited Dr. Wang Ting to introduce the comparative analysis of international HTA practices and trends. Dr. Wang first outlined the development of global HTA, then explained the trends in national HTA processes/policy changes, international cooperation, regulation/HTA docking, and the construction of HTA perspectives into drug development life cycles, patient involvement in HTA evaluation, and other aspects.
In the afternoon session, students reported on their group assignments. Students left the course series with a more comprehensive understanding of the importance and application of HTA.
Overall, the "Mini-Course Series on Health Technology Assessment" provided students with an excellent platform for communication, and it is hoped that they can apply the knowledge learned to future research and work.
"Internationally Renowned Expert Mini-Course Series " at the PKU Institute for Global Health and Development
The "Internationally Renowned Expert Mini-Course Series" is a distinctive program offered by the PKU Institute of Global Health Development. The course series features flexible scheduling, typically spanning one week, and invites internationally renowned scholars and experts to provide concentrated lectures on important topics, pressing issues, and cutting-edge research in global health and development. Participants will have the opportunity for scientific research exchange and receive professional guidance, contributing to the consolidation of professional foundations and the enhancement of professional capabilities.
The third edition of the "Internationally Renowned Expert Mini-Course Series" is scheduled for the summer of 2024. Applications are welcome at this time!
(Interpreted by Waverly Shi)
