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  1. Nur Farhana Mohamad, Izzuna Mudla Mohamed Ghazali, Junainah Sabirin, Tan Soek Siam, Rohani Jahis
    MyJurnal
    Introduction: Universal HBV and HCV screening among pregnant women is not a current practice in Malaysia. It is aimed to conduct a systematic review on available evidences in an effort to strengthen the national hepatitis screen-ing programs. Methods: Systematic search was performed from databases; Medline, Cochrane, PubMed and IN-AHTA. Relevant studies according to inclusion/exclusion criteria were critically appraised and evidence graded. Re-sults: From 782 titles identified, two systematic reviews, two retrospective cohort studies, two cross-sectional studies, one cost-utility analysis and one cost-effectiveness analysis were included. Universal antenatal HBV screening was associated with almost complete vaccination coverage for newborns. Replacing targeted screening with universal HBV screening was associated with increased identification of newborns indicated for HBV-immunization from 50% to 96%. Universal antenatal HBV screening had incremental cost-effectiveness ratio (ICER)s ranged from €2,032 to €26,181 per life year (LY) gained. As for HCV, targeted antenatal screening was associated with low HCV prevalence. Universal screening did not detect significantly more women with HCV infection than did targeted screening. One cost-effectiveness analysis found that universal antenatal HCV screening had ICER of €52,473 per LY gained and one cost-utility analysis reported ICER of £9,139 per QALY gained. Conclusion: Based on the above review, universal HBV screening in pregnant women is effective in increasing vaccination coverage for newborns. However, the ICERs had wide range. Therefore, local economic evaluation is needed to estimate cost implications before considering addition into national screening program. While for HCV, both universal and targeted screening in pregnant women had low detection rate thus high-risk approach screening is appropriate in Malaysia.
  2. Roza S, Junainah S, Izzuna MMG, Ku Nurhasni KAR, Yusof MAM, Noormah MD, et al.
    PMID: 30864531 DOI: 10.1017/S0266462319000023
    OBJECTIVES: The aim of this study was to provide a comprehensive overview of the evolution of health technology assessment (HTA) in Malaysia over the past decade.

    METHODS: We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation.

    RESULTS: Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated.

    CONCLUSIONS: HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.

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