Inside HITAP’s New GRU for Advanced Policy Analysis
Thailand’s Health Intervention and Technology Assessment Program Foundation (HITAP) has launched the Global Research Unit (GRU), a new research team designed to expand the impact of health technology assessment beyond traditional reimbursement roles. The initiative reflects HITAP’s growing international footprint and the increasing reliance of governments on HTA agencies to support broader system reform and policy design.
As health systems face more complex, cross-sectoral challenges from antimicrobial resistance to system-level redesign, HITAP argues that the conventional HTA toolkit is no longer sufficient. The GRU has been developed to close this gap, offering new methods and practical guidance to support faster, more relevant policymaking across Thailand and low- and middle-income countries (LMICs) globally.
Ms. Siobhan Botwright, Head of the GRU, explains that the new unit’s purpose is to answer policy questions “that standard HTA cannot fully address,” while offering insights that are both rigorous and feasible for implementation in constrained settings . This includes designing methodologies that governments can use when data is sparse, timelines are short, or decisions involve system-level consequences rather than product-level comparisons.
What You Need To Know
- HITAP launches the Global Research Unit to address policy questions that traditional HTA methods cannot fully answer.
- GRU integrates systems thinking, structured expert elicitation, and expanded economic evaluation to support LMIC decision making.
- Early contributions include system dynamics modeling for Thailand’s kidney therapy policy and AMR strategy evaluation.
- The unit aims to strengthen evidence-informed policymaking across national and international health systems.
GRU brings together experts in health economics, systems research, epidemiology, monitoring and evaluation, health promotion, and qualitative research. The team collaborates across HITAP units and with local and international partners to ensure that their recommendations, models, and tools remain relevant to diverse contexts.
The intention is not simply to generate evidence but to strengthen the conditions for evidence-informed policymaking. The GRU’s role includes helping policymakers anticipate system effects, diagnose implementation bottlenecks, and structure inquiries in ways that lead to actionable decisions rather than purely academic outputs.
Systems thinking as a central pillar
One of GRU’s early contributions is the integration of systems thinking into Thailand’s national policy work. The team built a system dynamics model that directly informed the country’s 2024 kidney replacement therapy policy, a landmark example of HTA guiding system-level decisions rather than isolated technology evaluations .
GRU has since extended this approach into work on caesarean section rates, maternal and child health among migrants, HTA system evaluation, and the mid-term review of Thailand’s National Strategic Plan on Antimicrobial Resistance (NSP-AMR). A forthcoming chapter in Thailand’s HTA guidelines will codify systems thinking principles, aiming to embed these methods into future evaluation practice.
Strengthening the quality of expert input
When data is limited or unobtainable, common in LMIC policy environments, governments often rely on expert judgment. GRU has developed a practical guide on the Delphi method to improve the reliability, transparency, and efficiency of structured expert elicitation. The team is also training HITAP researchers to apply these methods more consistently across projects.
This operational focus matters: many policy decisions cannot wait for new clinical evidence or large-scale data collection. A structured approach to expert input increases confidence in decisions made under uncertainty.
Another major GRU contribution is the development of guidelines for applying economic evaluation to broader kidney replacement therapy policy questions. Instead of focusing solely on technology comparisons, the guidance demonstrates how economic evaluation can inform service design, resource allocation, and strategic planning areas traditionally considered outside the core HTA remit.
The work was completed with international partners and is designed explicitly for LMIC applicability. Its objective is to help countries meaningfully adapt economic evaluation methods to their own research capacity, budget constraints, and health system realities.
GRU has identified several priority areas. These include systems thinking, antimicrobial resistance policy evaluation, context-specific HTA system assessment, implementation science to bridge the gap between policy decisions and real-world practice and advancing methods that integrate equity into decision-making frameworks .
This combines to form a vision of an HTA ecosystem that is more adaptive, inclusive, and aligned with real-world policymaking timelines. “Our overarching vision is to empower national, regional and international policymakers with contextually relevant HTA insights,” says Botwright. The GRU is positioned not only as a research unit, but as a catalyst for more responsive and effective policy development worldwide.
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