A roadmap toward implementing health technology assessment in Egypt

Ahmad Nader Fasseeh; Baher Elezbawy; Mary Gamal; Ahmed Seyam; Asmaa Abourawash; Mohsen George; Mohamed Anwar; Magdy Amin; Ahmed Yehia Khalifa; Amr Elshalakani; Ashraf Hatem; Sohir Abdelhamid; Hossam Elsamouly; Nader Fasseeh; Randa Adel; Hatem Dawood; Sherif Abaza; Zoltán Kaló

doi:10.3389/fpubh.2022.896175

A roadmap toward implementing health technology assessment in Egypt

Front Public Health. 2022 Dec 13:10:896175. doi: 10.3389/fpubh.2022.896175. eCollection 2022.

Authors

Ahmad Nader Fasseeh^{1

2}, Baher Elezbawy¹, Mary Gamal³, Ahmed Seyam⁴, Asmaa Abourawash⁵, Mohsen George^{4

6}, Mohamed Anwar⁷, Magdy Amin⁸, Ahmed Yehia Khalifa⁹, Amr Elshalakani¹⁰, Ashraf Hatem^{11

12}, Sohir Abdelhamid¹³, Hossam Elsamouly¹⁴, Nader Fasseeh¹⁵, Randa Adel¹⁶, Hatem Dawood¹⁷, Sherif Abaza¹⁸, Zoltán Kaló^{19

20}

Affiliations

¹ Syreon Middle East, Alexandria, Egypt.
² Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary.
³ Egyptian Authority for Unified Procurement, Medical Supply and Technology Management, Cairo, Egypt.
⁴ Universal Health Insurance Authority, Cairo, Egypt.
⁵ Egyptian Drug Authority, Cairo, Egypt.
⁶ Health Insurance Organization, Cairo, Egypt.
⁷ Department of Data Management and Decision Support, General Authority of Healthcare, Cairo, Egypt.
⁸ Department of Surgery, Military Medical Academy, Cairo, Egypt.
⁹ World Health Organization Representative Office, Cairo, Egypt.
¹⁰ Health, Nutrition and Population Global Practice, World Bank, Cairo, Egypt.
¹¹ Faculty of Medicine, Cairo University, Cairo, Egypt.
¹² American University in Cairo, Cairo, Egypt.
¹³ Egyptian Parliament Health Sector, Cairo, Egypt.
¹⁴ Pharmaco-Economics Unit, Police Hospitals, Cairo, Egypt.
¹⁵ Faculty of Medicine, Alexandria University, Alexandria, Egypt.
¹⁶ Takeda Pharmaceuticals, Cairo, Egypt.
¹⁷ Janssen Pharmaceutical Companies of Johnson & Johnson, Cairo, Egypt.
¹⁸ Syreon Middle East, Cairo, Egypt.
¹⁹ Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
²⁰ Syreon Research Institute, Budapest, Hungary.

Abstract

Background: The Egyptian healthcare system is currently in the early phase of health technology assessment (HTA) implementation. The aim of this study is to propose an implementation roadmap based on the national healthcare system status.

Methods: A survey was conducted among Egyptian healthcare sector decision-makers to assess the current and future (preferred) HTA implementation status in Egypt based on a widely used international scorecard methodology. Subsequently, interviews were conducted with experts representing middle- and top-tier management in the Egyptian healthcare system to interpret the survey results and recommend specific actions.

Results: Experts recommended more capacity-building programs for HTA and health economics. Additionally, they proposed establishing HTA units in separate healthcare authorities and merging them into a single central HTA unit in the long term. Regarding the scope of implementation, experts recommended commencing with the assessment of innovative pharmaceuticals, and thereafter, expanding the scope to cover all health technologies in the long term. Additionally, they recommended using innovative tools such as "multi-criteria decision analysis (MCDA)" for tendering, and "managed entry agreements" for reimbursement decisions. Local burden of diseases and costing studies were also recommended to facilitate the implementation of HTA.

Conclusion: Experts agreed that several actions are required for successful HTA implementation in Egypt, including coordination between HTA bodies, application of an explicit MCDA framework, and strengthening of local evidence generation. To implement these actions, investment in technical capacity-building is indispensable. Most experts favored using multiple and soft cost-effectiveness thresholds. Efforts should be made to publish HTA submission guidelines and timelines of the processes.

Keywords: Egypt; HTA; HTA implementation; health policy; health technology assessment; healthcare system.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Capacity Building*
Delivery of Health Care
Egypt
Surveys and Questionnaires
Technology Assessment, Biomedical* / methods

Grants and funding

001/WHO_/World Health Organization/International