Health Technology Assessment

The International Network of Agencies for Health Technology Assessment (INAHTA) defines Health Technology Assessment (HTA) as follows:

“The systematic evaluation of properties, effects, and/or impacts of healthcare technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences. Its main purpose is to inform technology-related policymaking in healthcare. HTA is conducted by interdisciplinary groups using explicit analytical frameworks drawing from a variety of methods.”

HTA plays an increasing role in determining which medical technologies are made available to patients throughout Europe; it is part of the overall EU strategy on innovation. An HTA aims to answer questions such as:

• Is the technology effective?
• If so, in which patients should it be used?
• What are the costs entailed in using the technology?
• How does it compare with other technologies?

Clearly, there is valid need to ask such questions, and used appropriately, HTA can be a useful tool in healthcare decision-making. Indeed, HTA providers argue that by identifying healthcare needs that are not being adequately addressed, or by highlighting areas where a lack of solid evidence is restricting uptake, HTA can help manufacturers target their research.

The medical technology industry supports the appropriate use of HTA; but appropriate should mean that the appraisal is a tool to assess potential value, not a cast-iron rule. For example, although HTA bodies may routinely look for data from robust, randomised controlled trials, the short product lifecycles in medical technology may make it difficult to provide such information. Therefore the evidence sought for the appraisal needs to be tailored to the specific technology and how that technology is likely to be used.

Another consideration is the scope for assessing value. An overly strict assessment, aimed principally at cost containment, risks ignoring wider benefits from new technologies. The full impact on quality of life, productivity and societal care costs should always be part of the appraisal. Also, technologies intended for surgical use are often associated with a learning curve for healthcare practitioners and a real insight into the true value may be very difficult to ascertain at the outset.

Although in theory the relationship between HTA and innovation should be synergistic, in practice the placing of undue weight on a single component, such as cost containment, can distort the outcome. Thus, instead of being used to support patient access to to innovative technologies, the HTA creates a barrier, making uptake and reimbursement more difficult.

The medical device industry, through Eucomed, is committed to collaborating with HTA agencies throughout Europe to ensure that HTA is applied appropriately, thus fostering rapid patient access to the effective, reliable and safe technologies as well as allowing healthcare systems to benefit from the advances urgently needed for the efficient allocation of healthcare resources and the delivery of sustainable healthcare.

More information on the contribution that HTA can make to informed policy and decision making can be found in the World Health Organization (WHO) brochure Health Technology Assessment of Medical Devices.