Current and future perspectives for the implementation of health technology assessment in Romania

Abstract Health Technology Assessment (HTA) is a complex methodology increasingly used worldwide to make transparent and evidence-based reimbursement decisions for health technologies. This study aims to describe the present environment and future prospects of HTA implementation in Romania based on the opinion of a wide range of national stakeholders. A survey was conducted using a questionnaire already applied previously to design HTA roadmaps for middle-income countries. Survey responses were collected from two sites. First, responses were collected among the participants of the National Conference of Pharmacoeconomics and Health Management in October 2017 at Brasov. Second, a purposive sampling was applied to contact HTA professionals from public organizations from October 2017 to February 2018. According to the respondents there is need for HTA capacity building by establishing postgraduate trainings in Romania. The funding for HTA should be a delicate balance between public and private resources. A national HTA body with the involvement of academic institutions was the preferred organizational structure. Results indicate that the quality assurance tools such as a methodological guideline or a critical appraisal checklist should be applied and the HTA process should be transparent. Respondents emphasized the importance of using primarily local data in certain categories for developing HTA evidence for decision-making. Our study indicates the need to improve the educational and methodological framework of HTA activities and to consider the transferability of international evidence in Romania, which can contribute to improve the efficiency of the health system.