Building bridges between academic research and policy formulation: the PRUFE framework - an integral part of Ontario's evidence-based HTPA process.

Healthcare expenditure in Ontario has been escalating at increasing rates and a growing proportion of this has come from medical devices and other technologies. A comprehensive evidence-based process for the assessment of new health technologies in Ontario was recently established (the Health Technology Policy Analysis [HTPA] process). Requests for funding for new technologies are directed through a department of the Ministry called the Medical Advisory Secretariat (MAS) who, using a systematic and evidence-based approach, provides information on the safety, effectiveness, and cost effectiveness of the technology to the Ontario Health Technology Advisory Committee (OHTAC). If the OHTAC determines that the evidentiary base for making recommendations is too uncertain, a request is made to reduce this uncertainty through the conduct of a 'real world' Ontario-based study. The Program for Assessment of Technology in Health (PATH) reduction of Uncertainty through Field Evaluation (PRUFE) framework is an iterative process for collecting new information, updating prior knowledge and providing new 'real world' evidence back to the Ministry regarding the cost effectiveness of new health technologies. MAS/OHTAC has undertaken evidence-based analyses for >50 new technologies. The PRUFE framework has been successful for reducing uncertainty and controlling healthcare expenditures while providing access and improving patient outcomes.