Health technology assessments
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Health technology assessment (HTA) is a multidisciplinary process that uses systematic and explicit methods to evaluate the properties and effects of a health technology. Health technology is conceived as any intervention ( test,
device A device is usually a constructed tool. Device may also refer to: Technology Computing * Device, a colloquial term encompassing desktops, laptops, tablets, smartphones, etc. * Device file, an interface of a device driver * Peripheral, any devi ...
, medicine, vaccine,
procedure Procedure may refer to: * Medical procedure * Instructions or recipes, a set of commands that show how to achieve some result, such as to prepare or make something * Procedure (business), specifying parts of a business process * Standard operat ...
,
program Program, programme, programmer, or programming may refer to: Business and management * Program management, the process of managing several related projects * Time management * Program, a part of planning Arts and entertainment Audio * Progra ...
) at any point in its lifecycle ( pre-market, regulatory approval, post-market, disinvestment). HTA aim is to inform "decision-making in order to promote an equitable, efficient, and high-quality health system''".' '' It has other definitions including "a method of evidence synthesis that considers evidence regarding clinical effectiveness, safety, cost-effectiveness and, when broadly applied, includes social, ethical, and legal aspects of the use of health technologies. The precise balance of these inputs depends on the purpose of each individual HTA. A major use of HTAs is in informing reimbursement and coverage decisions by
insurers Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management, primarily used to hedge ...
and national health systems, in which case HTAs should include benefit-harm assessment and economic evaluation." And "a multidisciplinary process that summarises information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value. Despite its policy goals, HTA must always be firmly rooted in research and the scientific method".


Purpose

Health technology assessment is intended to provide a bridge between the world of research and the world of decision-making. HTA is an active field internationally and has seen continued growth fostered by the need to support management, clinical, and policy decisions. It has also been advanced by the evolution of evaluative methods in the social and applied sciences, including
clinical epidemiology Clinical epidemiology is a subfield of epidemiology specifically focused on issues relevant to clinical medicine. The term was first introduced by Jean Paul in his presidential address to the American Society for Clinical Investigation in 1938. It ...
and health economics. Health policy decisions are becoming increasingly important as the opportunity costs from making wrong decisions continue to grow. HTA is now also used in assessment of innovative medical technologies like telemedicine e.g. by use of the
Model for assessment of telemedicine Model for assessment of telemedicine (MAST) is a framework for assessment of the value of telemedicine. Description Telemedicine services may have many different types of outcomes and can be studied in many ways. In order for those who develop ...
(MAST). Health technology can be defined broadly as:


History

The discipline of HTA was firsts developed in the U.S. Office of Technology Assessment, which published its first report in 1976. The growth of HTA internationally can be seen in the expanding membership of the International Network of Agencies for Health Technology Assessment (INAHTA), a non-profit umbrella organization established in 1993. Organizations and individuals involved in the production of HTA publications may also affiliated with international societies such as
Health Technology Assessment International Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organizat ...
(HTAi) and International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Academic courses, typically in Masters programs, are also offered in health technology assessment and management are also offered.


By country


United Kingdom

The United Kingdom's National Institute for Health and Care Research (NIHR) runs several research programmes which may be viewed as falling into the realm of Health Technology Assessment. Of particular note is the NIHR Health Technology Assessment programme, its longest running, which undertakes both conventional HTA in the form of Evidence Synthesis and modelling, and evidence generation with a large portfolio of pragmatic RCTs and cohort studies. The programme's research is regularly published in NIHR's journal Health Technology Assessment. Also in the UK, the Multidisciplinary Assessment of Technology Centre for Healthcare carries out HTA in collaboration with the health service, the NHS and various industrial partners. MATCH is organised into four themes addressing key HTA topics including Health Economics, Tools for Industry, User Needs and Procurement and Supply chain.


Canada

Canada also has a health technology assessment body called the Canadian Agency for Drugs and Technologies in Health (CADTH)


Italy

As of today, 11 Italian Regions have issued specific regional laws or regulations to manage HTA activities and processes at regional level: Abruzzo, Basilicata, Emilia-Romagna, Lazio, Liguria, Lombardia, Piemonte, Puglia, Sicilia, Toscana, and Veneto. In another 4 Regions (Calabria, Marche, Umbria, and Valle D’Aosta) and in the 2 autonomous Provinces of Bolzano and Trento, HTA is performed at different levels, even if no legislation has been produced yet. The World Health organisation provides an overview of countries and their corresponding HTA agencies.


See also

* Horizon scanning * Pharmacoeconomics


References


External links


Health Technology Assessment International (HTAi)

International Network of Agencies for Health Technology Assessment (INAHTA)
{{Evidence-based practice Impact assessment Medical technology Technology assessment Life sciences industry