UEMO’s position paper on HTA

05/06/2021 23 Views
UEMO’s position paper on HTA

UEMO 2021-065-HTA Position Paper

At the end of the HTA network collaboration for the European regulation and before the implementation, UEMO wants to express its gratitude to the work done by EUnetHTA and the EC. UEMO was happy to participate in the debates: a new challenge for a profession centered on individual relationships1, to be confronted to the impact of new technologies and the principles of assessment from a European point of view.

The shared decision process2 in general practice is the key moment of HTA in real life, when GPs who are the main prescribers, discuss with their patients the best choice, including the important dimensions: the bio-psycho-social aspects, continuity of care and coordination, multi-morbidity and quaternary prevention3 (first do not harm). This shared decision takes place in a difficult context “compounded by the implications of ever-increasing expectations of perfect health and the effects of multinational commercial pressures”, as said Iona Heath1.

GPs need confidence in HTA process, its methodology based on EBM, while remaining free from conflicts of interest and while being transparent. GPs need good information in plain language and which is also understandable by patients and which allows for an honest discussion.

GPs consider that for new technologies which are linked with information and communication technologies, confidentiality and the safety of data both during transmission and in storage (cloud) is a very important topic to discuss in the interest of the patient.

GPs are concerned by pathways and procedures, by the practical use and feasibility of a new technology. For example in the covid epidemic, GPs were at the frontline and good information and decision algorithms (including them in the design) were mandatory to discuss and debate with patients.

In a recent study on personalized medicine4, 90% of patients want to discuss with their GPs if such technology is implementable. The idea that industry can have a direct-to-consumer link without any mediation is a commercial vision. General practice will maintain its role in the future and will need sustainable development as a speciality.

UEMO informed GPs throughout the HTA discussions5,6,7.

UEMO wants to continue the collaboration with HTA in the future:

  • UEMO can help for the identification of experts in general practice.
  • UEMO has contacts with the majority of general practice associations in Europe and can help with interviewing GPs and gathering opinions in Europe (focus groups for example8) .
  • UEMO has permanent contacts with Wonca and its networks and other special interest groups who can promote specific GP research in HTA.
  • As a stakeholder UEMO can remember how to integrate new technologies while respecting the values of general practice (Wonca tree9).

 References

  1. Heath, Iona. « View of Health Technology Assessment from the Swampy Lowlands of General Practice ». International Journal of Technology Assessment in Health Care 20, no 1 (2004): 8186. https://doi.org/10.1017/s0266462304000832.
  2. Elwyn, Glyn, Christine Dehlendorf, Ronald M. Epstein, Katy Marrin, James White, et Dominick L. Frosch. « Shared Decision Making and Motivational Interviewing: Achieving Patient-Centered Care across the Spectrum of Health Care Problems ». Annals of Family Medicine 12, no 3 (juin 2014): 27075. https://doi.org/10.1370/afm.1615.
  3. Jamoulle, Marc. « Quaternary Prevention, an Answer of Family Doctors to Overmedicalization ». International Journal of Health Policy and Management 4, no 2 (février 2015): 6164. https://doi.org/10.15171/ijhpm.2015.24.
  4. Cohidon, Christine, Regula Cardinaux, Jacques Cornuz, Robin Chenal, Béatrice Desvergne, Idris Guessous, Daniela Cerqui, et Daniel Widmer. « May Direct-to-Consumer Genetic Testing Have an Impact on General Practitioners’ Daily Practice? A Cross-Sectional Study of Patients’ Intentions towards This Approach ». BMC Family Practice 22, no 1 (26 avril 2021): 79. https://doi.org/10.1186/s12875-021-01428-6.
  5. Widmer Daniel, Patrick Ouvrard, et Marie-Christine Bonnamour. « Partie 1: HTA et la place des médecins de famille ». Primary and hospital care: médecine interne générale, 3 juillet 2019. https://doi.org/10.4414/phc-f.2019.10089.
  6. Widmer Daniel, Patrick Ouvrard, et Marie-Christine Bonnamour. « Partie 2: UEMO et HTA : qu’avons-nous fait ? » Primary and hospital care: médecine interne générale, 31 juillet 2019. https://doi.org/10.4414/phc-f.2019.10090.
  7. Widmer D. Mission impossible ? Editorial. To be published June 2021. Primary and hospital care.
  8. UEMO announces publication of 2018 Report: “Benchmarking Deployment of eHealth among GPs” https://www.uemo.eu/uemo-announces-publication-of-2018-report-benchmarking-deployment-of-ehealth-among-gps/
  9. The European definition of general practice/family medicine https://www.globalfamilydoctor.com/site/DefaultSite/filesystem/documents/regionDocs/European%20Definition%20of%20general%20practice%203rd%20ed%202011.pdf

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