Exploring the linkage between Health Technology Assessment and Decision Making during COVID-19 public health emergency in a developing country: Analysis of processes and results

HASDEU SANTIAGO; JORGELINA ALVAREZ; BELIERA, ANABEL; JULIAN SANCHEZ VIAMONTE

INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE

CAMBRIDGE UNIV PRESS

Lugar: Cambridge; Año: 2023

0266-4623

The decision-making (DM) process in public administration is subject of research that approaches it from different perspectives and disciplines. Evidence-based policies, such as health technology assessment (HTA), are not the only support on which public policies are designed. During COVID-19 pandemic WHO and other organizations developed HTA to guide DM. Despite these recommendations were aligned, inadequate variability was observed in the health technologies recommended and reimbursed by different provincial Health Ministries in a federally organized developing country like Argentina. The processes and results of DM on health technologies for COVID-19 in Health Ministries of Argentina were inquired.A triangulation of quantitative and qualitative methods was carried out in a retrospective design. Information was retrieved from years 2020-2021 through document review of official webpages, surveys and interviews with decision makers of the 25 argentinian Ministries of Health. We analysed the recommendations and reimbursement of seven different health technologies. Ivermectine, Inhaled Ibuprofen, Convalescent plasma and Equine serum were widely recommended by most of the health ministries of Argentina, outside a clinical trial context, with risks for patients and a huge opportunity cost. Despite an important HTA institutional capacity, the impact of HTA organizations and their technical reports was limited. Even when Health Ministries with institutionalised HTA units had more adherence to WHO recommendations, we identified the influence of different technical and political criteria. Power relations within and outside the administration, the pharmaceutical industry and academics, the media, social pressure, the Judicial and Legislative powers, and the political context, strongly influenced decision making.