Health Technology Assessment - World Hospitals and Health Services

11 luglio 2017

The WHO defines health technology assessment (HTA) as “the systematic evaluation of properties, effects, and/or impacts of health technology …. a multidisciplinary process to evaluate the social, economic, organizational and ethical issues of a health intervention or health technology.” It defines health technology as the “application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives.” In this issue of the World Hospitals and Health Services (WHHS) Journal, the contributing authors look at the different ways in which HTA can contribute to informed policy decision making in the health sector, including advantages and some caveats. Countries throughout the world spend from under 2 percent (low income countries) to over 5 percent (OECD countries) of total health expenditure on medical devices and diagnostics, and somewhere in the range of 10 to 20 percent on pharmaceuticals and vaccines. Given that many countries outside the OECD import technology in foreign currencies, spending on health technology sometimes constitutes a substantial part of the non-staff health care budget in developed countries. As indicated by many of the contributing authors in this issue of the Journal, good HTA can therefore significantly contribute towards improving not only care quality but also financial sustainability in the health sector. In a 2015 WHO survey on HTA among member states (111 of 145 responded to the survey), most countries reported having a formal process for systematically compiling, analyzing and synthesizing relevant information and scientific evidence to support health care policy decision making. Countries used HTA for different purposes depending on their income level, but most countries gathered the information for planning and budgeting purposes. Surprisingly however, fewer than half of the countries with a formal process had legislative requirements for the consideration of analysis results. Critics of HTA often claim that HTA is often devised by antitechnology bureaucrats and policy researchers who do not have a full grasp of the underlying scientific sophistication of technologies under assessment, or the commercial challenges and costs of translating bench research from the lab to something that benefits patients. Most of the major breakthroughs in medicine in during the past Century have occurred through entrepreneurs developing new drug, vaccines, medical devices and diagnostic equipment. 

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