Promises and Pitfalls of Health Technology Assessment

Abstract

Over the last decades, a continuous rise in health care expenditure has been observed in all Western countries, partly, at least, due to the rapid diffusion of novel treatments and technologies. This growth in health care costs is not sustainable in the long run and hence strategies are being developed to set priorities about which interventions to fund and implement. Although radiotherapy is commonly accepted to be a very cost-effective treatment strategy, it is not immune from this general tendency toward cost-consciousness and cost-containment. This chapter will guide the interested radiation oncology professional through some theoretical aspects of health technology assessment, economic evaluation and cost accounting. In order to illustrate the concepts, recent examples from the economics literature on radiotherapy treatments are discussed. Additionally, this chapter will review some diverging results and conclusions from economic analyses of similar interventions and hence highlight potential pitfalls in the interpretation of health economic data. The chapter concludes by discussing which strategies could be pursued to support the economic future of our specialty.