technologies and innovation
Ruth McDonald and Tom Walley
In recent decades health technology assessment (HTA) has been of increasing interest to health policymakers and researchers. Health technologies have the potential to prolong life or enhance quality of life for patients. However, in modern health systems, which face a gap between demand for care and available resources, such technologies also present challenges. Governments have responded to these challenges by seeking to 'manage' access to new and existing health technologies in a proactive fashion, rather than merely reacting to their development. This means that health services managers are increasingly expected to play a proactive role in the process.
This chapter provides an introduction and overview to the subject of HTA and explains why this is an important issue for those charged with managing health services. The first section describes what is meant by HTA before briefly examining its role in relationship to priority setting. We then outline the various stakeholders involved in HTA processes and consider the challenges posed by attempts to incorporate competing stakeholder perspectives. Following this we discuss HTA in theory and practice, drawing on examples from various countries to illustrate the influence of contextual factors on the development of HTA and the extent to which its outputs influence decision making. We then examine the role of managers with regard to HTA and consider the challenges faced by managers in the context of applying HTA findings. In the next section we present other challenges which face the HTA process and discuss ways in which HTA needs to adapt to the changing nature of healthcare provision and demand in the twenty-first century. The chapter concludes with a brief summary of key points.