從英國發展早期感知與預警系統的經驗為例，看台灣健康照護體系之應用

Appling early awareness and alert (EAA) systems to Taiwan healthcare system–an example learned from UK

新醫療科技日新月異，售價與日俱增，前瞻性評估已被用來做為感知和預警健康照護系統決策單位的方法學，以利於對未來可能造成照護體系影響的新醫療科技能盡早就所需的法規、財務衝擊、環境建置、人力培訓、倫理考量等事宜預做安排與規劃。英國有多年執行早期感知與預警系統的經驗，辨識對國民健康服務有影響的新醫療科技是其範疇之一，借鏡英國篩選出新醫療科技清單的經驗可做為健保總額匡列年度新醫療科技預算之參考。惟政策制定者應先決定納入分析科技的類型、時機點、篩選條件和選題機制、產品價格和健保收載價格落差的處理、產品上市延期影響總額執行的因應措施，以及給付優先順序設定的條件。 Due to the rapid development of health technologies and the ever-rising healthcare costs, horizon scanning, also known as early awareness and alert (EAA) activities, is the method aiming at identifying new and emerging health technologies that may have impact on health system and early alerting and informing policy-makers to arrange and plan following issues, such as regulatory environment, financial management, workplace preparedness, training and education, and ethics. The Horizon Scanning Research and Intelligence Centre in UK has several years of experience in EAA activities. Identifying new and emerging health technologies influencing the National Health Service is one activity within their remit. We could learn the experience of EAA's processing to produce their final lists of health technologies as the guidance when planning our own fiscal budget for new health technologies under the scheme of global budget. However, policy-makers should first decide the scope, the timing within reasonable frame, filtration criteria, who and how to process the topic selection, how to manage the gap between manufacturer's suggested price and National Health Insurance price, the strategies to cope with the impact, resulted from the unpredictable delayed approval of health technologies, on the executing fiscal budget, and the setting of the criteria to prioritize the health technologies within the fixed amount under the fiscal budget.