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New technologies with the potential to improve the health of populations are continuously being introduced. But not every technological development results in clear health gains. Health technology assessment provides evidence-based information on the coverage and usage of health technologies, enabling them to be evaluated properly and applied to health care efficaciously, promoting the most effective ones while also taking into account organizational, societal and ethical issues. This book reviews the relationship between health technology assessment and policy-making, and examines how to increase the contribution such research makes to policy- and decision-making processes. By communicating the value and potential of health technology assessment to a wider audience, both within and beyond decision-making and health care management, it aims ultimately to contribute to improve the health status of the population through the delivery of optimum health services.
This book is open access under a CC-BY license. Policy-making to address grand challenges faces greater complexity than any previous project of modernization. Future scenarios are haunted by uncertainty and there is real ambivalence as to the values that policy should strive for. In this situation decision-makers look to research and innovation to provide answers and solutions. But neither can the great transitions ahead be planned by science, nor will conventional methods of innovation bring such transitions about. A turn to interactive governance is therefore underway with policy-makers and citizens becoming increasingly involved in processes of deliberating futures. Technology Assessment (TA) is the art of structuring such processes. TA goes beyond traditional expert policy analysis by systematically combining a multi-disciplinary evidence base with participatory approaches to policy deliberation. TA thus seeks to act as a hub for serious and transparent dialogue between policy, industry, science, and society about the challenges ahead and the available options for overcoming them responsibly. This volume offers an up-to-date account of the expansion of technology assessment capacities across new European member states. The contributions of this volume are written by leading European researchers and practitioners in technology assessment (TA) and are based on the PACITA (Parliaments and Civil Society in Technology Assessment) project.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA’s features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.
A timely work describing how localized hospital-based health technology assessment (HB-HTA) complements general, ‘arms-length’ HTA agency efforts, and what has been the collective global impact of HB-HTA across the globe. While HB-HTA has gained significant momentum over the past few years, expertise in the field, and information on the operation and organization of HB-HTA, has been scattered. This book serves to bring this information together to inform those who are currently working in the field of HTA at the hospital, regional, national or global level. In addition, this book is intended for decision-makers and policy-makers with a stake in determining the uptake and decommissioning of new and established technologies in the hospital setting. HTA has traditionally been performed at the National/Regional level by HTA Agencies, typically linked to governments. Yet hospitals are the main entry door for most health technologies (HTs). Hospital decision-makers must undertake multiple high stakes investment and disinvestment decisions annually for innovative HTs, usually without adequate information. Despite the existence of arms-length HTA Agencies, inadequate information is available to hospital decision-makers either because relevant HTA reports are not yet released at the time of entry of new technologies to the field, or because even when the report exists, the information contained is insufficient to clarify the contextualized informational needs of hospital decision makers. Therefore, there has recently been a rising trend toward hospital-based HTA units and programs. These units/programs complement the work of National/Regional HTA Agencies by providing the key and relevant evidence needed by hospital decision makers in their specific hospital context, and within required decision-making timelines. The emergence of HB-HTA is creating a comprehensive HTA ecosystem across health care levels, which creates better bridges for knowledge translation through relevance and timeliness.
This report addresses the concepts and controversy surrounding health technology assessment in Europe, with a particular focus on selected Member States including Sweden, the Netherlands, Finland, France, Germany and the United Kingdom. It is intended to identify and address current considerations regarding HTA methodological and process issues related to the prioritization and financing of modern health care. In particular, it describes the processes and challenges for identifying and prioritizing assessments; assesses and compares current assessment methods and procedures; and highlights the barriers to effective implementation. The report also ascertains the roles and terms of engagement of key stakeholders, and captures the opportunities and challenges for the use of HTA guidance in general priority-setting, decision-making and health-care provision.
People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.
"This thoughtful and comprehensive book represents the best work I have seen on the current situation concerning medication policies in the EU. It is not just that this is a very up-to-date compendium of facts and data across a wide variety of domains that impact on pharmaceutical regulation. The book is also strong on analysis of those facts as well." Jerry Avorn, Harvard Medical School. "This book offers a comprehensive examination of approaches to manage pharmaceutical expenditures in Europe. It is a must-read for those who seek to understand and navigate the changing regulatory environment for medicines in the European Union." Bernie O'Brien, McMaster University, Canada. The rising cost of pharmaceutical expenditures in many European countries is of concern to governments required to make effective use of health care budgets. Taking a broad perspective that encompasses institutional, political and supranational aspects of pharmaceutical regulation, this book examines approaches used to manage pharmaceutical expenditure across Europe and what impact these strategies have had on efficiency, quality, equity and cost of pharmaceutical care.Regulating Pharmaceuticals in Europe is an important book for students of health policy, regulation and management, and for health managers and policy makers. The editors: Elias Mossialos is Brian Abel-Smith Professor of Health Policy at the London School of Economics and Political Science and a Research Director of the European Observatory on Health Systems and Policies. Monique Mrazek is a Health Economist (Europe and Central Asia region) for the World Bank and formerly a Research Officer in Health Economics for the European Observatory on Health Systems and Policies. Tom Walley is Professor of Clinical Pharmacology at the University of Liverpool and Director of the UK National Health Technology Assessment Programme. Contributors:Julia Abelson, Christa Altenstetter, Vittorio Bertele’, Christine Bond, Marcel L. Bouvy, Colin Bradley, Steve Chapman, Anna Dixon, Michael Drummond, Pierre Durieux, Edzard Ernst, Armin Fidler, Eric Fortess, Richard Frank, Silvio Garattini, Leigh Hancher, Ebba Holme Hansen, Steve Hudson, Kees de Jonchere, Panos Kanavos, Sjoerd Kooiker, Jean-Marc Leder, Graham Lewis, Donald W. Light, Alistair McGuire, Elias Mossialos, Monique Mrazek, Maria Pia Orru', Govin Permanand, Guenka Petrova, Munir Pirmohamed, Dennis Ross-Degnan, Frans Rutten, Steven Soummerai, David Taylor, Sarah Thomson, Tom Walley.
Worldwide simultaneous effects of technologies, international challenges such as climate change as well as shifting relationships between science and society call for approaches that can address these issues on a global level. This book examines the potential of Technology Assessment (TA), as an until now mainly national and Western concept, to take on this global level and provide answers to these pressing questions.
This Handbook provides a comprehensive overview of technology assessment (TA) practices, theories, methods and cultures across the globe. Highlighting the significant influence of rapidly changing technology on human life and development, it examines diverse perspectives on how TA can be developed to better meet the challenges of the future. This title contains one or more Open Access chapters.