Health technology assessment

Author(s):  
Chiara de Waure ◽  
Carlo Favaretti

The aim of this chapter is to help the public health practitioner to: learn what health technology assessment (HTA) is in healthcare and in public health domains; understand that HTA is a powerful tool for the governance of the healthcare systems at all their levels: macro (national and regional), meso (hospitals and healthcare services organizations), and micro (healthcare professionals); understand that HTA is a multidisciplinary, multidimensional and multistakeholder process; gain knowledge about how to develop an HTA report to support decision makers in taking the best possible decisions; know the main sources of data to base the assessment contents on evidence; recognize the role of HTA in public health

2000 ◽  
Vol 16 (2) ◽  
pp. 299-302 ◽  
Author(s):  
David Banta ◽  
Wija Oortwijn

Health technology assessment (HTA) has become increasingly important in the European Union as an aid to decision making. As agencies and programs have been established, there is increasing attention to coordination of HTA at the European level, especially considering the growing role of the European Union in public health in Europe. This series of papers describes and analyzes the situation with regard to HTA in the 15 members of the European Union, plus Switzerland. The final paper draws some conclusions, especially concerning the future involvement of the European Commission in HTA.


2002 ◽  
Vol 18 (2) ◽  
pp. 192-198 ◽  
Author(s):  
John M. Eisenberg ◽  
Deborah Zarin

Governments may perform health technology assessment (HTA) in their roles as a regulator in the public interest, as a source of information for decision makers in the public and private sectors, and/or as a purchaser or provider of healthcare services. The U.S. government's roles in the health sector as a regulator, source of information, and purchaser and provider of services are influenced both by characteristics of that sector and by its stakeholders' effectiveness in influencing national health policy debates.


Author(s):  
Jackie Street ◽  
Tania Stafinski ◽  
Edilene Lopes ◽  
Devidas Menon

ObjectivesThe terminology used to describe community participation in Health Technology Assessment (HTA) is contested and frequently confusing. The terms patients, consumers, public, lay members, customers, users, citizens, and others have been variously used, sometimes interchangeably. Clarity in the use of terms and goals for including the different groups is needed to mitigate existing inconsistencies in the application of patient and public involvement (PPI) across HTA processes around the world.MethodsWe drew from a range of literature sources in order to conceptualize (i) an operational definition for the “public” and other stakeholders in the context of HTA and (ii) possible goals for their involvement. Draft definitions were tested and refined in an iterative consensus-building process with stakeholders from around the world.ResultsThe goals, terminology, interests, and roles for PPI in HTA processes were clarified. The research provides rationales for why the role of the public should be distinguished from that of patients, their families, and caregivers. A definition for the public in the context of HTA was developed: A community member who holds the public interest and has no commercial, personal, or professional interest in the HTA processConclusionsThere are two distinct aspects to the interests held by the public which should be explicitly included in the HTA process: the first lies in ensuring democratic accountability and the second in recognising the importance of including public values in decision making.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Di Macio ◽  
M Caricato ◽  
C Primieri ◽  
C Favaretti ◽  
C De Waure

Abstract Issue Although the recognized importance of Health Technology Assessment (HTA) in fostering health policy and management, little is known and differences emerge in the state of the art of HTA development and use in public health decisions. Description of the Problem HTA applied to public health interventions could lead to improved population's health, risk factor reduction and high quality services. All these factors represent the basis of health care system sustainability. Nevertheless, there is a lack of evidence about the application of HTA to public health. In this light, the Section on HTA of the European Public Health Association (EUPHA) is conducting a Delphi process in order to define a shared roadmap for the implementation of HTA in public health. Results A literature search was first performed on PubMed to identify useful documentation for drafting the roadmap. Taking clues from Kalò et al., who drafted an HTA roadmap scorecard to support HTA implementation in Central and Eastern Europe, a preliminary core set of actions and pillars to pave the way for the implementation of HTA in public health, was identified. Then, a group of HTA experts was invited to participate to the Delphi process with the aim to build consensus on the final set of actions and pillars to include in the roadmap. Lessons Evidence on the ways to strengthen the role of HTA in public health decisions is scant and the development of a shared roadmap could be useful to identify milestones to do it. Key messages HTA applied to public health could promote an efficient, sustainable, equitable and high-quality health system. Nevertheless, the role of HTA in taking public health decisions should be strengthened. As evidence on the application of HTA in public health is scant, the development of a shared roadmap could enhance fostering its use in taking decisions on public health interventions.


2019 ◽  
Vol 35 (S1) ◽  
pp. 19-19
Author(s):  
Bart Bloemen ◽  
Maarten Jansen ◽  
Wouter Rijke ◽  
Wija Oortwijn ◽  
Gert Vanderwilt

IntroductionHealth Technology Assessment (HTA) is where facts and values meet: the evidence that is considered relevant to the assessment of a technology depends on the value framework used. In the context of the European project VALIDATE (Values in doing assessments of healthcare technologies), we assessed to what extent this interplay between facts and values is acknowledged in HTA reports on non-invasive prenatal testing (NIPT). Our aim is to gain a better understanding of this fact-value relationship, and to contribute to the development of capacity for ethical analyses in HTA.MethodsFive reviewers independently analyzed HTA reports on NIPT, obtained from the National Institute for Health Research (NIHR) HTA database, by answering a structured questionnaire on: (i) arguments, values, and conclusions; (ii) relations between values and collected evidence; (iii) operationalizations of the values involved. Ethical argumentation was analyzed using the method of specifying norms. This method holds that for general, abstract ethical principles to reach concrete cases, principles need to be specified in such a way as to achieve maximal coherence between different value commitments and practice. The results of the analysis were discussed in joint meetings to arrive at a consensus on interpretation.ResultsOur results show that the pivotal role of values in defining what counts as relevant evidence and why, is rarely acknowledged. The same holds for the importance of specifying values as a means to achieve greater coherence between the use of healthcare technologies and a range of values.ConclusionsThere is ample room for improvement in clarifying the role of values in HTA: they can serve to explain and justify what evidence is considered relevant to the assessment of a healthcare technology. Recognizing that abstract values need specification in order to reach concrete cases opens up new opportunities for exploring in what way values are affected by healthcare technologies.


2019 ◽  
Vol 35 (S1) ◽  
pp. 48-48
Author(s):  
Leonor Varela-Lema ◽  
Janet Puñal-Riobóo ◽  
Paula Cantero-Muñoz ◽  
Maria José Faraldo-Vallés

IntroductionDecision making regarding national population-based prenatal and newborn screening policies is recognized to be highly challenging. This paper aims to describe the formalized collaboration that has been established between the Spanish National Public Health Screening Advisory Committee (PHSAC) and the Spanish Network of Health Technology Assessment (HTA) agencies to support the development of evidence- and consensus-based recommendations to support this process.MethodsIn-depth description and analysis of the strategic and methodological processes that have been implemented within the Spanish National Health System prenatal and newborn screening frameworks, with special emphasis on the role, actions, and responsibilities of HTA agencies.ResultsThe role of HTA agencies is threefold: (i) support the PHSAC by providing evidence on safety, effectiveness and cost/effectiveness of the screening tests/strategies, as well as contextualized information regarding costs, organizational, social, legal and ethical issues; (ii) collaborate with the PHSAC in the development of formal evidence- and consensus-based recommendations for defining population screening programs, when required; (iii) analyze real-world data that is generated by piloted programs. This paper will provide real-life examples of how these processes were implemented in practice, with a special focus on the development of the non-invasive prenatal testing (NIPT) policy. Recommendations for NIPT were developed by a multidisciplinary group based on the European network for Health Technology Assessment (EUnetHTA) rapid assessment report and the predictive models that were built using national statistics and other contextualized data.ConclusionsThe current work represents an innovative approach for prenatal and newborn screening policymaking, which are commonly difficult to evaluate due to the low quality of evidence and the confounding public health issues. The paper raises awareness regarding the importance of joint collaborations in areas where evidence is commonly insufficient for decision making.


2009 ◽  
Vol 25 (S1) ◽  
pp. 224-230 ◽  
Author(s):  
Sadasivan Sivalal

Objectives: Malaysia, as a rapidly developing country, has been facing tremendous pressures in its attempts to maximize scarce resources. Despite this problem, Malaysia has made great strides in developing its health services, and has successfully provided good access to the population to healthcare services, reduced the incidence of many communicable diseases, and improved life expectancies and other global indices of health care, some of which are comparable to that of developed countries.Methods: The Health Technology Assessment (HTA) Unit was set up in Malaysia in August 1995 in the Ministry of Health Malaysia and has since grown tremendously in size and resources. To date, forty-three in-depth assessments have been carried out, and the recommendations of these assessments were subsequently implemented. In addition, approximately 140 rapid assessment reports were produced in response to requests from policy and decision makers. HTA has been able to provide input into formulation of national and Ministry of Health Malaysia policies, and provide a basis for clinical practice guidelines development, input into purchasing decisions, regulation of drugs, as well as advertisements related to health.Results: A major challenge is sustainability of the program, to be able to have trained personnel competent to take on the demanding tasks of assessments and the sustained efforts that are required. In addition, there need to be constant efforts to create awareness of the utility of HTA so that its services are used and its full potential realized. The scope of services may also need to be expanded to include an early warning system.Conclusions: Malaysia has successfully implemented a health technology program that has had major impact on policy formulation and decision making at various levels. Challenges may be faced in sustaining and developing the program further.


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