Richa Goyal, Principal HEOR, IQVIA

Mahendra Kumar Rai, Senior Director HEOR and RWE, EVERSANA

Background:

India is a country with an ever increasing disease burden and underfunded health system, thus creating challenges for the government to sustain the health demands of the population¹. To answer the above problem statement Health technology assessment (HTA) appears to be a promising and a globally accepted tool which helps in creating efficient and equitable resource allocation². HTA is a multidisciplinary process that includes information about the medical, social, economic and ethical issues which is related to the use of health technology in a systematic, transparent, unbiased, robust manner. Further, it aims to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value. It can be said that HTA is a process which systematically evaluates health interventions to ensure they represent good value for money.

This led to the creation of Health Technology Assessment in India (HTAIn) which included an institutional structure created in the Department of Health Research (DHR), Ministry of Health and Family Welfare (MoHFW), New Delhi, India. The strategic position of DHR in terms of functional linkage to MoHFW as well as National Institute for Transforming India (NITI) Aayog – the strategic policymaking arm of Central Government, and several other regulatory bodies implies that all factors leading research towards policymaking are favorably aligned³.

Another initiative by the government to overcome the above stated problems includes the Ayushman Bharat Digital Mission (ABDM). This aims to make India Atmanirbhar or Self-reliant in providing universal health coverage to all the citizens. It aligns with the goals and objectives of the National Health Policy (NHP) 2017 and the National Digital Health Blueprint that will create a digital infrastructure for providing healthcare services across the country. The infrastructure would consist of large amounts of health-related data and various standardized digital services which will ensure confidentiality and security of personal information of the public^4,5.  ABDM has the following advantages:

1. Empower individuals with accurate information and help in informed decision making thus increasing accountability of healthcare providers.
2. It will help digitize the claims process and enable faster reimbursement.
3. Policy makers and program managers will have better access to data which will help in more informed decision making by the Government. 
4. Researchers will benefit from such data as they will be able to study and evaluate the effectiveness of various programs and interventions.

Ayushman Bharat Health Account Number (ABHA Number): ABHA number is a 14-digit number which will help in uniquely identifying a participant in India’s digital healthcare ecosystem. ABHA number will establish a strong and trustable identity that will be accepted by healthcare providers and payers across the country⁵.

Updates:

1. The HTAIn funded PGIMER, Chandigarh, India which is a member of the HTAIn resource hub network is conducting a nationally representative costing study on 'Cost of health services in India (CHSI)'. The vision was to develop a national reference cost database that achieves transparency along the lines of the UK national reference costs or Australia’s national reference price⁶. 
2. National Health Claims Exchange (HCX)-Sandbox’ under Ayushman Bharat Digital Mission (ABDM): The NHA has developed a national Health Claims Exchange (HCX) to enable exchangeability of health claims. This will serve as a protocol for exchanging claims-related information among various stakeholders including payers, providers, beneficiaries, regulators, and observers. Several of its features include it to be interoperable, machine-readable, auditable, and verifiable which helps ensure that the information being exchanged is accurate and trustworthy⁷.

References:

1. Patel V, Parikh R, Nandraj S, Balasubramaniam P, Narayan K, Paul VK, et al. Assuring health coverage for all in India. Lancet. 2015;386:2422–35. 
2. World Health Organisation. Out-of-pocket health expenditure (% of private expenditure on health). World Health Organization Global Health Expenditure Database. Geneva: WHO; 2016. 
3. https://htain.icmr.org.in/about-us/about-htain. Accessed on 19^th April 2023.
4. https://www.makeinindia.com/national-digital-health-mission
5. https://ndhm.gov.in/. Accessed on 19^th April 2023.
6. https://www.cgdev.org/blog/building-better-evidence-base-health-technology-assessment-lessons-india. Accessed on 17^th April 2023.
7. https://ibgnews.com/2023/04/19/national-health-claims-exchange-hcx-sandbox-under-ayushman-bharat-digital-mission-abdm/. Accessed on 17^th April 2023.