While this commentary is based on Canadian experiences, the authors do look at examples of health technology assessments elsewhere, applying the National Institute for Health and Care Excellence (NICE) as the gold standard for others to follow.
Health technology assessments are “an evidence-based policy tool that helps inform decision-making on how to balance demand and supply pressures for new or existing technologies within a health-system budget.”
This document is going to be very useful for developers of new technological solutions, and those who are procuring them. It will inform the developers about factors, standards, and stakeholders they need to consider when designing new health technologies, and it will help procurement teams consider the evidence behind the technology so that they can prepare more informed business cases for investment. The evidence provided will also help patients and their clinicians to understand the health benefits and the reasoning behind rationing decisions and resource allocation.
When adopting new technologies, the following impacts should be considered, in terms of systematic evidence retrieval:
- Cost and economic evaluation
Most importantly, a consistent approach must be taken when choosing and implementing new technologies, as they have the potential to improve the quality of care delivered. However, they can also increase the financial burden on the health organisation, which is why it is so important to base any decisions about new health technologies on the best available evidence, because sometimes, although the technology does provide increased health benefits, the cost may be too high to be justifiable. It is important that the decisions about new technologies should be transparent to everyone, developers, users, beneficiaries, and decision-makers.
The authors of this commentary describe the different approaches to health technology assessments, and conclude that if HTAs are consistently used, health services could be more effective in their selection and implementation of new health technologies, and patients would benefit because they could see a clear rationale for their adoption. They include an overview of HTAs in other countries, including New Zealand, England, and Scotland, and they offer some insight into new approaches for health organisations to take.
The commentary also covers the measurements of benefits from new technologies, focusing on the quality-adjusted life-year (QALY), which looks at “one year lived in a perfect state of health”.
The authors conclude that HTAs are a way of balancing supply and demand fairly, while considering the costs involved. They suggest that UK’s value-based pricing activities demonstrate how by using HTA economic evaluations to support decisions made about new technologies is more beneficial than just saying “yes” or “no”, without justification based on quality evidence.
This is a very important document, because it considers all the key players in the development, procurement, and application of innovative health technologies. The decisions can often be controversial, and that is why it is so important that the decisions made are based on the best evidence.
Commissioners and procurement teams should reflect within your departments about whether you apply evidence when making decisions about new technologies. Do you have the skills to search for the evidence or do you have access to a library service that can find the evidence for you?
By incorporating evidence, your decisions will be more robust and credible, and patients and doctors are more likely to adhere to them.
Capturing value from health technologies in lean times (PDF)
A Blomqvist, C Busby, D Husereau
C.D. Howe Institute