Using CLA Approaches to Institutionalize Health Technology Assessment in Ukraine
Health technology assessment (HTA) is a multi-disciplinary process countries use to systematically make policy decisions about health technologies (from medicines and devices to procedures and health interventions). No health system can afford every new medicine or device, and countries face difficult choices, often in the face of limited resources and competing interests, which opens the door for corruption. As Ukraine works toward universal health coverage, and its citizens demand better quality health care, the country recognized that use of HTA processes would guide decision-makers to select medicines systematically, using evidence to determine the best value for the health care system. Management Sciences for Health (MSH), through the USAID/Safe, Affordable and Effective Medicines for Ukrainians (SAFEMed) Project partnered with Ukrainian health authorities to introduce HTA as an evidence-based decision-making process. Over the course of this work, SAFEMed systematically applied collaborating, learning, adapting (CLA) approaches relying on a wide range of stakeholders and regular reflection and adjustments that resulted in Ukraine's full institutionalization of HTA in just over three years.
Notably, an HTA roadmap incorporated CLA to guide the successful formation of the institutions, policies, human resources, and methodical and open processes to select medicines that bring the best value to Ukrainian patients. While Russia's invasion of Ukraine in February 2022 slowed the pace, the Government of Ukraine's HTA department continued to function and even assessed four new medicines. Meanwhile, SAFEMed has continued to build the capacity of local stakeholders to make evidence-based policy decisions related to access to essential medicines.