Spain

Earlier this year, the Spanish authorities introduced endobronchial valves for persistent air leakage into the Common Package of Benefits of the National Health System. This decision was based on the reports (HTA report and monitoring study) by the Evaluation Unit of the Canary Islands Health Service (SESCS). On July 22, 2021, the Resolution outlining the conditions for the provision of the service was published.

On June 30, 2021, it was announced that the Government of Spain, through the Ministry of Health, will invest nearly 400 million euros throughout this year in the development of the High-End Technology Equipment Investment Plan (INVEAT) of the National Health System (SNS). The objectives are to reduce the obsolescence of the current SNS technology park and to raise the average density rate of high-tech equipment per 100,000 inhabitants. The renovation of equipment amounts to 585 units and the expansion to 262.

On June 30, 2021, the Interterritorial Council of the National Health System has approved the agreement of the Committee of designation of Centers, Services, and Reference Units (CSUR) for the designation of 21 new CSUR for seven pathologies, including ophthalmological diseases and the renovation of designation of six CSUR for adults with congenital heart disease.

On June 30, 2021, the Interterritorial Council of the National Health System has agreed to create the Digital Health Commission aiming to contribute to co-governance with the Autonomous Communities in this matter. The draft "Digital Health Strategy", prepared by the General Secretariat for Digital Health, Information, and Innovation, has been presented to open a process of consultation and observations.

On June 30, 2021, the Interterritorial Council of the National Health System has approved the inclusion of real-time continuous glucose monitoring (rt-CGM) systems in the Common Package of Benefits for adult patients meeting certain criteria. The inclusion of rt-CGM devices in the Common Package of Benefits means that these devices are now guaranteed to the defined population nationwide.

The Health Sciences Institute in Aragon (IACS) systematically evaluates healthcare technologies and facilitates the promotion of research, effective innovation, and decision-making in health services through knowledge management. Currently, the IACS is working on assessments of efficacy, effectiveness, and safety of intraoperative radiation therapy in breast cancer, determination of preeclampsia biomarkers SFlt-1 and PlGF, treatment of congenital ventricular septal defect by cardiac catheterization, and others.

In May 2021, the Agency for Health Quality and Assessment of Catalonia (AQuAS) published a report on next-generation sequencing (NGS) for molecular diagnosis and selection of therapeutic targets in oncological diseases. The studies identified present favorable results on the diagnostic efficacy of the NGS-based gene panels; the evidence on the clinical effectiveness of NGS panels remains limited. The authors emphasize the need for further studies.

The Galician Scientific and Technical Advice Unit in Spain (AVALIA-T) systematically evaluates healthcare technologies and provides decision-makers with critically reviewed information about their efficacy, safety, and effectiveness. Currently, the AVALIA-T is working on assessments of ventricular assist devices in pediatric patients with an indication for permanent destination therapy, bronchial thermoplasty for severe acute asthma, effectiveness and safety of epiduroscopy in the treatment of failed back surgery syndrome, and other topics.

The Agency for Health Technology Assessment of Andalusia Autonomous Community in Spain (AETSA) systematically evaluates healthcare technologies and provides decision-makers with critically review information about their efficacy, safety, and effectiveness. Currently, the AETSA is working on assessments of laser-induced heat therapy in epilepsy surgery, stereotactic radiation therapy for the treatment of refractory ventricular tachycardia, implantable Holter monitor with ILink Online technology for prolonged cardiac monitoring, and other topics.

In February 2021, the Health Technology Assessment Agency of the Health Institute Carlos III published the report for the efficacy and safety of robotic spinal surgery compared to manual surgery in spinal fusion.

In November 2020, the General Directorate of Basic Package of National Health System and Pharmacy Services published the Resolution on the agreement of the Commission of Benefits, Insurance, And Financing in relation to the proton therapy technique. The key points of the agreement include the recommendation for the creation of an interdisciplinary committee in each autonomous community to evaluate each specific case of proton therapy and therapeutic indications.

In the middle of 2020, the Galician Scientific and Technical Advice Unit (Unidad de Asesoramiento Científico-técnico, Avalia-T) released a health technology assessment on clinical Effectiveness of newborn screening for inborn errors of metabolism by MS/MS that aimed to update the data collected in the pilot study. It is recommended to define health indicators, optimum and acceptable levels of some process indicators.