Discussion: Patient Participation in HTA—Evidence of Real Change?

Abstract

Only a few years ago, it was unlikely we would find enough evidence of patient involvement in HTA to fill a chapter, let alone a whole book. Clearly, progress has been made, and undoubtedly there will be much more to come; nevertheless, it may be timely to ask: How much real change has taken place in HTA bodies and, as importantly, what has been the impact? This chapter explores this question by considering the evidence from the various countries and/or regions presented in Part III. My own experience, working with patient organizations in Canada and internationally via IAPO, allows me to critically review processes from the perspective of patient advocates who are keen to be involved in HTA processes. First, there are systematic similarities and differences in the ways in which patients are participating in HTA reflecting ideological, developmental, and cultural factors. Second, the goals of stakeholders for patient participation vary both within a healthcare system and across systems, with some goals naturally more conducive to patient involvement than others. Third, there are conditions that support or detract from patient participation in HTA, and examination suggests some best practices that we can build upon.