臺灣、加拿大與英國病友參與醫療科技評估的現況與展望

The Current Status and Prospects of Patient Involvement in Health Technology Assessment among Taiwan, Canada, and the United Kingdom

醫療科技評估（health technology assessment, HTA）是現今評估新醫療科技且提供臨床或給付決策實證資料的重要方法，透過蒐集醫療未被滿足的需求、臨床療效、成本效益、財務衝擊、病友參與以及其他面向。我國醫藥品查驗中心所屬的國家醫療科技評估中心已成立近10年，在協助健保署評估新藥給付的流程中，扮演重要角色，而近年來世界各國備受重視的病友意見參與也成為HTA重要的一環。我國透過病友意見分享平台的建立，在健保署共同擬定會議前，得以收集病友的相關經驗；同時也透過法規的修訂，增加病友直接參與會議的機會。本文進一步去比較英國與加拿大現行體制後，發現許多值得借鏡的措施，包含較長的意見收集區間、病友發言投票權、意見收集後的重複利用以及反饋等。因此，本文統整目前我國病友意見參與醫療科技評估的現況，並建議未來的發展方向。

Health technology assessment (HTA) is a vital method of evaluating new health technology recently, which supports clinical and policy decision through collection of unmet medical needs, clinical benefit, cost-effectiveness, budget impact, patient involvement, and others. Our National Institute for Health Technology Assessment has been established for nearly ten years and is vital in assisting the National Health Insurance Administration (NHIA) in evaluating reimbursements for new drugs. In recent years, patient involvement has also become an essential part of HTA around the world. Through the construction of a patient opinion-sharing platform, the user experience from patients can be collected before the NHIA Pharmaceutical Benefit and Reimbursement Scheme Joint committee (PBRS) meeting. At the same time, through the revision of regulations, the opportunity for patients to directly participate in the meeting has been increased. We also learned from the United Kingdom and Canada about some potential strategies to strengthen the adoption of patient opinion in the NHIA’s decision making process, including a longer opinion collection period, patients' right to speak and vote, reuse, and feedback of opinions after collection. In summary, this study aims to provide the current status and prospects of patient involvement in HTA in Taiwan.