Insights and implications: an analysis of the studies undertaken by Health Technology Assessment in India (HTAIn)

Health technology assessment sets explicit priorities to maximize health gains and support universal health coverage. Health Technology Assessment in India (HTAIn) was set up to ensure efficient allocation of public health expenditure impacting 1.4 billion Indians. We conducted an analysis to summarize the research undertaken by HTAIn thus far and recommend the way forward.

We shortlisted 33 of the 39 studies published by HTAIn on their website in October 2023. We analysed diseases treated, types of interventions evaluated, aspects of HTA addressed and whether the intervention was cost effective. The quality of each study was rated against Drummond's checklist and the Indian Reference Case. Results were charted and tabulated where possible, and a narrative synthesis of findings was set down.

Overall, 24.2% (n = 8) of the studies focused on interventions for maternal and neonatal disorders, 33.3% (n = 11) of the interventions were devices, and 45.5% (n = 15) were intended for screening. All of the studies addressed economic efficiency, 75.8% (n = 25) evaluated clinical efficacy, and 54.5% (n = 18) spoke of effectiveness; 45.5% (n = 15) addressed all three. Against the Indian Reference Case, six studies scored above 8, and the rest scored between 4.55 and 7.95. Equity and heterogeneity (population subgroup analysis) are the parameters that fared worst.

A formal framework for choosing interventions for evaluation would make the decision-making process explicit. While difficult to evaluate, operational feasibility, equity and heterogeneity need to be appraised to ensure that policy-makers draw considered conclusions. We recommend that areas for disinvestment be identified, given health budget constraints.