The implementation of HTA in medicine pricing and reimbursement policies in Indonesia: Insights from multiple stakeholders

PLoS One. 2019 Nov 27;14(11):e0225626. doi: 10.1371/journal.pone.0225626. eCollection 2019.

Abstract

Objectives: This study aimed to identify the barriers and facilitators to improve the use of health technology assessment (HTA) for the selection of medicines listed in the e-Catalogue and the national formulary in Indonesia.

Methods: Semi-structured interviews were conducted to collect qualitative data. Purposive sampling was used to recruit the stakeholders consisting of policymakers, a pharmaceutical industry representative, healthcare providers, and patients. The data were analyzed using directed content analysis and following the COnsolidated criteria for REporting Qualitative studies (COREQ).

Results: The twenty-five participants interviewed agreed with the use of HTA for supporting the e-Catalogue and the national formulary and perceived the advantages of HTA implementation outweighed the disadvantages. Barriers mentioned were a lack of capability of local human resources, financial incentives, a clear framework and insufficient data. Strategies suggested to overcome the barriers were establishing (inter)national networks to build up capacity, setting up departments of HTA in several universities in Indonesia, and introducing a clear HTA framework. Facilitators mentioned were the ambition to achieve universal health coverage, the presence of legal frameworks to implement HTA in the e-Catalogue and the national formulary, and the demands for appropriate medicine policies.

Conclusions: Several barriers are currently hampering broad implementation of HTA in medicine pricing and reimbursement policy in Indonesia. Solutions to these issues appear feasible and important facilitators exist.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Health Plan Implementation / standards*
  • Health Policy / trends*
  • Humans
  • Male
  • Middle Aged
  • Prescription Drugs / economics*
  • Prescription Drugs / standards
  • Qualitative Research
  • Reimbursement Mechanisms / legislation & jurisprudence*
  • Reimbursement Mechanisms / standards
  • Stakeholder Participation*
  • Technology Assessment, Biomedical / organization & administration*
  • Universal Health Insurance

Substances

  • Prescription Drugs

Grants and funding

This work was financially supported by DIKTI (to RW) and LPDP (to SI) scholarships from the Ministry of Research, Technology and Higher Education, and the Ministry of Finance of the Republic Indonesia, respectively. The DIKTI and LPDP had no direct role in research design, data collection, analysis and interpretation, or manuscript writing and publication.