Repository of Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research

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1 Repository of Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research Surasak Saokaew, PharmD Takashi Sugimoto, RN, PHN Isao Kamae, MD, DrPH Nathorn Chaiyakunapruk, PharmD, PhD 1

2 Rationale HTA has been grown for value-based healthcare decision worldwide Formally adopted in 3 countries in Asia South Korea Taiwan Thailand Thailand : adopted Japan : strong interest and had been expected formal adoption in the near future 2

3 Rationale HTA requires timely supply of research works Healthcare database has become a widely accepted source for HTA in Western and European countries Despite potential availability of those kinds of databases in Asia-Pacific countries, these has been no compilation of existing healthcare databases in Asia region. 3

4 Research question How the existing health-related databases can be potentially used for health technology assessment in Thailand and Japan? 4

5 Objectives To explore and describe the availability of existing health databases in Thailand and Japan To list out relevant databases in Thailand and Japan To assess or describe databases which can be potentially used for HTA 5

6 Methods Literature search: online and/or hard copy Google, PubMed, etc. References from published articles Network of people with experiences of health database Describe the nature of databases Classify databases into 3 groups Population, household and health survey Disease surveillance and registry Administrative and claimed database Assess the potential use for HTA 6

7 Methods Potential of HTA Database must at least identify one of the domains according to Velasco et al. IJTAHC 2002;18(2):

8 Domains Outcomes/Variables Box 1 Domains for database potentially used in HTA Domain Outcomes/variables Safety/Efficacy/ Effectiveness Mortality Morbidity Disability Adverse event Quality of life (e.g. EQ-5D, SF36, HUI) Life year, Quality-adjusted life year Social/ethical Compliance Acceptance Satisfaction Organizational/professional Utilization (e.g. service or technology utilization) Length of stay Personnel required Material required (e.g. hospital bed) Economic Cost/price Income/economic status Epidemiological Prevalence Incidence Health state Demographic (e.g. age, sex, education) 8

9 Results 40 databases included 20 databases from Thailand 20 databases from Japan Characteristics of databases Name of database Host Scope/objective Time/sample size Design Data collection method Population/sample Variables 9

10 Results Population, household and health survey Data Population Household Economic status Health status Well-being Health utilization and expenditure Treatment pattern 10

11 Results Disease surveillance and registries Data Natural history Assessing and monitoring safety and effectiveness Evaluating quality of care and performance Estimating cost-effectiveness Reflect real world patient, practice, and outcomes Longtime frame Useful for estimation the burden of disease 11

12 Results Data Administrative and claimed database Reimbursement data Clinical variables, procedure use, and charge Cross-sectional and longitudinal data collection of clinical and economic outcomes Very useful for HTA at low cost and in a short time Rare event/outcome is more easily identify 12

13 Results 13

14 Discussion To the best of our knowledge, this is the first study in Asia-Pacific region that provided the list of healthcare database and assessed the potential for HTA research. These databases imply an abundance of data with high potential for HTA research 14

15 Discussion Advantages Access larger sample Database use weighted/cluster sample is representative nationawide Minimal time and cost Potentially useful for rare disease/event Provided real-world data Multiple functions for applications 15

16 Discussion Disadvantages Potential bias (i.e. non RCT) Sophisticated statistical approaches may adjust for potential confounding (covariate adjustment, instrumental variables, propensity score, etc.) Data collection error Missing data 16

17 Limitation Population, household and health survey Lack of relevant data on specific product Subjectivity Recall bias Disease surveillance and registries Inherent limitation of observational study Not suitable for test hypothesis, but useful to generate hypothesis Incidence and prevalence is not true because registry always came from cases register (denominator is difficult to define) 17

18 Limitation Administrative and claimed database Data quality (e.g. missing, coding error) Large size overcome missing data problem Limited information on clinical and symptom Absence of population denominator Lack of information of the difference between cost and charge 18

19 Conclusion Use of databases for HTA research has strengths and limitations. Decision makers are referred to the summary and critical appraisal about these before using database-based studies for HTA Our study provided initial source for data search; not the comprehensive list Further study describing how database have been used in HTA is warranted 19

20 Thank you The authors greatly appreciate a research grant for this study given by Japan Center for Economic Research