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Towards Greater Impact in Health Technology Assessment: System Dynamic Approach for New and Emerging Technologies in Iran Publisher Pubmed



Goudarzi Z1 ; Marzaleh MA2 ; Nikfar S3 ; Kebriaeezadeh A3 ; Zenouz RY4 ; Abdollahiasl A3 ; Nouhi M5
Authors
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Authors Affiliations
  1. 1. Faculty of Medical Information and Management, Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
  2. 2. Department of Health in Disasters and Emergencies, Faculty of Medical Information and Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
  3. 3. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square, 16 Azar St., Tehran, 1417614411, Iran
  4. 4. Department of Operations and Information Technology Management, Faculty of Management, Kharazmi University, Tehran Between Shahid Qorani and Ostad Nejatollahi, Somia St, No 242, Tehran, 159996415, Iran
  5. 5. National Institute for Health Research, Tehran University of Medical Sciences, Keshahvarz Blvd, Vasal Shirazi Street, Bozorgmehr East Street, Number 70, Tehran, 62921000, Iran

Source: DARU# Journal of Pharmaceutical Sciences Published:2024


Abstract

Purpose: As classical health technology assessment models fail to predict the complexities of related impacts, the application of modeling techniques such as systems dynamics simulation (SD) is essential. This study aimed to develop an SD model to predict the outcomes of access to a new medicine in Iran. Methods: This study extracted the important and influential variables in providing access to new pharmaceutical technologies by comprehensively reviewing previous research and combining the technical knowledge of experts in this field. The variables were incorporated into the systems thinking framework and modeled using dynamic systems tools, followed by simulation and testing in VENSIM. The model was piloted for deferoxamine and deferasirox in thalassemia. Various tests were used to evaluate the validity and reliability of the model. The model was designed for a ten-year horizon (2018–2028) for medicines selected as the pilot. Results: The variables extracted from the panel of experts encompassed the primary and short-term impacts of access to newly emerged medicine and long-term impacts regarding the economy, health, and society. After modeling, the leverage points presented for the problem with the greatest impact or effectiveness in access to new medicine included the policy determining the amount of medicine supply, the import and production of medicine, the prevalence and incidence of disease, insurance coverage, and treatment adherence. Conclusion: The SD models allow the researchers to evaluate the efficiency and health outcomes of a new pharmaceutical more precisely in the health system in Iran. Graphical abstract: (Figure presented.) © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023.
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Shekoufeh Nikfar (1)