Member Profile

Name: Professor Tracy Merlin

Current position: Managing Director, Adelaide Health Technology Assessment (AHTA),School of Public Health, University of Adelaide

Qualifications: BA(Hons), MPH, PhD

Area of Expertise/Research Interests:

  • Developing methodologies for evaluating diagnostic tests to help policy-makers decide whether the tests should be publicly funded

 

  • Developing methodologies for evaluating co-dependent technologies (eg. the combination of a test and a drug; two tests; a drug and a device). For example, pharmacogenetics / personalised medicines.

 

  • Developing methodologies for evaluating mobile medical applications

 

  • Exploring the impact of health technology assessment (HTA) on policy-makers’ decisions

 

  • Exploring how clinicians interpret evidence-based clinical practice guidelines

 

  • Exploring the impact of evidence-based clinical practice guidelines on clinical practice

 

  • Comparing the utility of different methods for grading recommendations in evidence-based clinical practice guidelines

 

  • Comparing decision thresholds, between health systems, for determining the cost-effectiveness of technologies

 

  • Mapping the impact of HTA on the Australian health system

 

  • Mapping and categorising the different types of HTA and developing quality assurance criteria for each type of HTA product

 

 

When was the Centre established?

2001

How long have you been the Director of the Centre?

I have been the Managing Director at AHTA for 7 years. Prior to that I was the Manager of the Centre.

What is your background?

I have a PhD in Medicine, a Masters Degree in Public Health (specialising in clinical epidemiology and biostatistics), an Honours degree in Psychology and postgraduate qualifications in project management and online higher education. My doctoral studies concerned the methods for evaluating diagnostic tests and personalised medicines to inform public funding decisions.

I co-founded AHTA in 2001. As a consequence, I lead a large and experienced team of researchers, skilled statisticians, IT specialists, systems analysts, programmers and data managers, undertaking multi-million dollar applied research and evaluation activities on behalf of government and non-government agencies.

I have an interest in methodology and so have developed approaches (fortunately implemented at the national level), for horizon scanning for new health interventions and disinvesting from established medical services. I developed internationally-accepted classifications for health technology assessment products, as well as an evidence hierarchy and evidence grading method used to produce NHMRC-endorsed evidence-based clinical practice guidelines. I pioneered the first methodological approach internationally for evaluating personalised medicines, particularly pharmacogenetic treatments, for a public funding decision.

Apart from the methodological work, I have written well over 150 systematic literature reviews, clinical practice guidelines and health technology assessment reports and have published widely in the academic peer reviewed literature.

I am a Director on the Board of the International Network of Agencies for Health Technology assessment (INAHTA) and am the current Chair of the English Editorial Board of the international HTA Glossary. I was a member of the Scientific and Professional Programs Committee of Health Technology Assessment international (HTAi) for five years and was a member of the international scientific program committee for the HTAi conference held in Tokyo in 2016. I am active locally as a current member of the South Australian Medicines Evaluation Panel and the SA Health Policy Advisory Committee.

I coordinate a University short course, and another online course, on Health Technology Assessment which forms part of two Masters programs.

What is the Centre’s background?

Adelaide Health Technology Assessment (AHTA), is located in the School of Public Health at the University of Adelaide, South Australia. AHTA conduct primary and secondary research to support best practice in the evaluation of health interventions.

Our mission is to provide:

Expertise in health technology assessment by:

  • Evaluating the safety, effectiveness and value for money of health interventions
  • Predicting the impacts of these health interventions on individuals and society
  • Contributing to best practice, locally, nationally and internationally.

To provide expertise in the design and conduct of studies, statistical analysis and interpretation, supported by systems that enable high quality data collection and management.

To provide leadership, education and capacity building in the generation, evaluation and interpretation of evidence.

How many people does the Centre employ?

40

What are your themes or core bodies of work in the centre?

AHTA primarily undertakes contract research on behalf of the Australian Government Department of Health, to evaluate health services, medicines and other interventions to inform health policy and public funding decisions. This can include assessing the safety, effectiveness and cost-effectiveness of medical services that are being considered for Medicare funding; and the appraisal of pharmaceuticals to determine whether they warrant funding under the Pharmaceutical Benefits Scheme.

As recently as 2015, the staff from the former Data Management and Analysis Centre (DMAC) were integrated into AHTA. These staff had previously provided multi-disciplinary support for clients undertaking research and data intensive projects in the health field and have extensive experience assisting research clients, government departments and non-government agencies. These staff brought a wealth of knowledge with regard to registry and clinical trial data management and analysis, which nicely complements the evidence-based policy and modelling activities already being undertaken by AHTA.

Is there one major achievement of the Centre that stands out for you?

This is a difficult question! Much of our work is confidential (for Government) and so we are not at liberty to share details. The work with the most impact on the health system has probably been the evaluations we undertook of the new class of oral direct acting antiviral medications for hepatitis C. This helped inform the Government position on the use of these drugs.

What trends have you seen in funding support for HSR in Australia and or New Zealand over the last decade?

Health technology assessment – a subset of HSR – has seen fairly stable funding support via contract research over the past decade. Investigator-initiated research in HSR has not been very well supported to date.

Around the world, researchers are constantly trying to ensure that research is relevant to decision makers. How do you ensure that you keep in touch with policy makers?

Health technology assessment is a policy science. Our role is to provide evidence-based information to policy-makers about health interventions that will affect the health system. We, therefore, work very closely with policy makers and ensure our research is closely aligned with decision-maker needs.

What do you think has been the most significant change in the Australian health system in the last 10 years?

Transitioning of health care in hospital to health care in the home and community.

What is the one change to the health system you would like to see in the next 10 years?

Better regulation and (introduction of) robust evaluation processes for the reimbursement of medical apps (and similar technologies) when used as part of a clinical service.

What would you like to see come out of this Association as a local and national body?

Advocacy for funding, support and understanding of the critical importance of health services research.

Back to Member Profiles