The assessment of technologies to be purchased in healthcare realities, Hta (Health Technology Assessment), “is a key theme in our 2022 Conference for two reasons. The first concerns our competence and profession: we, in fact, take care of Hta every day in the activity we carry out. The second reason is linked to the really important institutional moment we are experiencing“, he claims Lorenzo Leogrande, president of the XXII National Conference of the AIIC, Italian Association of Clinical Engineers, in Corso Riccione. The AIIC summit is aiming for a real “relaunch” of the importance of HTA in the Italian health system, highlighting known issues and envisaging new scenarios.
“Through the Delegated Law 53/2021 – remembers Leogrande – the national legislation for the two regulations 745/2017 and 746/2017 concerning medical devices and in vitro devices is being substantially implemented. In this regulation there will also be a part relating to the strengthening of the HTA especially in relation to procurement. This is why we wanted to tackle the issue in a direct confrontation with the central purchasing bodies, which deal with the purchasing process on a daily basis “.
Today the link between Hta and procurement is substantially absentobserve the clinical engineers in a note, because “the central purchasing bodies – notes Leogrande – collect the needs of healthcare companies, aggregate demand and, in innovation tenders, adopt direct entrusting mechanisms. Instead we hope for the diffusion of a Hta culture that applies regardless of the methodologies and regulatory obligations. Then we must work to ensure that the purchasing processes take into account, where possible, the assessments made. It is clear that this connection is must create on the basis of a common language “.
Since 2017, with the implementation of the control room for the HTA which clearly and precisely outlined the process for the purchase of new technologies, the model has had difficulty in being translated into practice, the note continues. In fact, the functionality of a rational and structured model, sanctioned by a State-Regions agreement, and of a control room, consisting of the Ministry of Health, National Agencies (Agenas and Aifa) and representatives of Regions, for the production of Hta. “Despite the stop of the pandemic years, the Regions have used elements of the process and for this reason a working group has been set up with the mission of trying to make this relationship more efficient.“, highlights Americo Cicchettidirector of Altems, High School of Economics and Management of Health Systems.
However, a relationship that needs to be stabilized, updated and relaunched, as the experts involved in the debate within the Aiic event remarked. Today it is necessary to update the State-Regions agreement of 2017 that defined the national HTA program – it is the reflection – and then provide for a periodic update to make it authoritative and representative for all those involved. We also need “resources and the assumption of responsibility – exhorts Cicchetti – Among the missing elements in this moving scenario, one certainly concerns resources, because it has always been thought of developing Health Technology Assessment without investments and this obviously makes the company slow if not immobile. whole system “.
In conclusion, Leogrande claims that Aiic not only “observes the entire HTA system from within, but intends to be a driving force. We, as professionals and together with other professionals, know perfectly the advantages and the current criticalities and we will be protagonists of proposals and suggestions to national and regional decision-makers, so that the opportunity offered by the Pnrr and recent regulations is not lost. so that the Health Technology Assessment can find an Italian way to evaluate health technologies that can offer authentic value, guaranteeing sustainability and correct management “.
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