Health technology assessment: a framework.

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In a time where there is growing pressure on healthcare budgets, there is increased scrutiny of new health technologies, their effectiveness, safety and costs.1 It is in this context that Health Technology Assessment (HTA) has become increasingly important. The purpose of HTA is to provide policymakers with evidence to inform decision-making and develop guidance on the reimbursement and administration of new health technologies in a national healthcare system. As such, HTA is regarded as a bridge between research evidence and health policy.2 HTA is a multidisciplinary process, encompassing diverse aspects such as medical, economic, organisational, social and ethical considerations. The term ‘health technology’ is used in its broader sense and, with it, we typically refer to any product or activity that is used to promote health in any way, for instance, by preventing or treating disease, improving rehabilitation, and long-term care.3 HTA can aid a national health system with making decisions on how to allocate the often limited healthcare funds to different health technologies. Healthcare systems are faced with many new and old health technologies and insufficient resources to fund all of these. The result is a concept known as ‘opportunity cost’, which describes the value of the achievable benefits forgone by funding one technology, which comes at the expense of another.4 HTA can help decide which health technologies best to fund. At its heart is often an economic evaluation that compares health technologies in terms of their costs, clinical effectiveness, side effects, impact on HRQoL, impact on organisations, among others. There are different types of economic evaluation and they can be distinguished by the outcomes that are considered in each (table 1).4 Cost analysis studies consider the costs associated …