Search results

Health systems are progressively stressed by health spending, which is partially explained by the increase in the cost of health technologies. Countries have defined processes to prioritize interventions to be covered. This study aims to compare for the first time health technology assessment (HTA) processes in Canada and Chile, to explain the factors driving these decisions.

This is a health policy analysis comparing HTA processes in Canada and Chile. An analysis of publicly available documents in Canada (for CADTH) and Chile (for the Ministry of Health (MoH)) was carried out. A recognized political science framework (the 3-I framework) was used to explain the similarities and differences in both countries. The comparison of processes was disaggregated into eligibility and evaluation processes.

CADTH has different programmes for different types of drugs (with two separate expert committees), whereas the MoH has a unified process. Although CADTH’s recommendations have a federal scope, the final coverage is a provincial decision. In Chile, the recommendation has a national scope. In both cases, past recommendations influence the scope of the evaluation. Pharmaceutical companies and patient associations are important interest groups in both countries. Whereas manufacturers and tumour groups are able to submit applications to CADTH, the Chilean MoH prioritizes applications submitted by patient associations.

Institutions, interests and ideas play important roles in driving HTA decisions in Canada and Chile, which is demonstrated in this novel analysis. This paper provides a unique comparison to highly relevant policy processes in HTA, which is often a research area dominated by effectiveness and cost-effectiveness studies.

Climate-related disasters are the most representative in terms of recurrence and impacts. To reduce them, risk transfer is a key strategy for climate risk management. However, this approach does not consider the socioeconomic vulnerability of each population group, limiting its effectiveness. The objective of this paper is to improve and increase the usefulness of risk transfer through the Differential Risk Transfer (DRT) approach.

A comprehensive and systematic review of the state of the art on Differential Approach (DA) is presented, and its connection with existing models of vulnerability to disasters is analysed. Through epistemic deliberations, an operational definition of Differential Risk Transfer (DRT), as well as its advantages are discussed. Finally, general guidelines are presented for the implementation of the DRT in a specific context.

The results confirm that DA presents a clear relation with the models for the study of disaster vulnerability. The small group discussions agree with the usefulness of DRT for improving climate-related risk management.

This paper argues for the inclusion of the DRT approach in the climate risk management strategies aiming to fill the disaggregated data gaps that limit the potentiality and accuracy of risk transfer schemes worldwide.

This innovative approach improves the accuracy of the risk transfer mechanisms through the recognition of the differences of ethnicity, gender and life cycle that increase socioeconomic vulnerability to climate-related disasters.