May 2012 - Internet Resources Digest


Health Technology Assessment

Internet Resources Digest
May 2012

American International Health Alliance
LRC project

The Internet Resources Digest (previously – Health Resources Digest) is distributed free of charge as a service of the American International Health Alliance (AIHA). If this document is to be re-distributed or posted on another Web site, we request that it be posted in full/without alteration, and credit is given to the AIHA as the source of the document.

Health Technology Assessment

Health Technology Assessment is a multi-disciplinary field of policy analysis that examines the medical, economic, social and ethical implications of the incremental value, diffusion and use of a medical technology in health care. It is intended to provide a bridge between the world of research and the world of decision-making. Health technology assessment is an active field internationally and has seen continued growth fostered by the need to support management, clinical, and policy decisions. It has also been advanced by the evolution of evaluative methods in the social and applied sciences, including clinical epidemiology and health economics. Health policy decisions are becoming increasingly important as the opportunity costs from making wrong decisions continue to grow...”

(From Wikipedia

HTA International and National Organizations

INAHTA – International Network of Agencies for Health Technology Assessment

INAHTA - a non-profit organization was established in 1993 and has now grown to 53 member agencies from 29 countries including North and Latin America, Europe, Asia, Australia, and New Zealand. All members are non-profit making organizations producing HTA and are linked to regional or national government.

INAHTA's key communication form is Internet. The INAHTA website and Members-only section include information about on-going activities.

  • The Brief series is intended as a forum for member agencies to present overviews of recently published reports. INAHTA Briefs are published regularly and placed on the INAHTA website as soon as they become available.
  • HTA Checklists are an aid to furthering a consistent and transparent approach to HTA. They also provide information on the purpose, methods, and contents of an HTA report.
  • Joint projects involve the member agencies in collaborative efforts to evaluate medical technologies of mutual interest.
  • INAHTA also produces a newsletter in three languages on current initiatives and activities among member agencies, new projects within the Network, recent developments and trends in health policy research, publications in the field, and upcoming events.


The HTAi Vortal

Health Technology Assessment International (HTAi)  is the global scientific and professional society for all those who produce, use, or encounter HTA. HTAi embraces all stakeholders, including researchers, agencies, policymakers, industry, academia, health service providers, and patients/consumers, and acts as a neutral forum for collaboration and the sharing of information and expertise. With members from 59 countries and six continents, HTAi is a thriving global network. HTAi is actively committed to international collaboration, and has signed formal Memoranda of Understanding with the World Health Organization and the International Network of Agencies for HTA (INAHTA). From time to time, HTAi takes part in external initiatives in collaboration with other organizations. Vortal is a service offered by the HTAi Interest Sub-Group on Information Resources (IRG). It is a web-based source of HTA information on processes, methodology and tools available to all. You can for example find information there on HTA institutions, information retrieval, emerging technologies, health economics or educational materials. You can browse this information or also search the indexed webpages via the search box.


The World Health Organization (WHO) launched the Evidence-Informed Policy Networks (EVIPNet) in 2005.  EVIPNet promotes the systematic use of health research evidence in policy-making. Focusing on low and middle-income countries, EVIPNet promotes partnerships at the country level between policy-makers, researchers and civil society in order to facilitate both policy development and policy implementation through the use of the best scientific evidence available. EVIPNet comprises networks that bring together country-level teams, which are coordinated at both regional and global levels. The networks are established in Africa, Asia, America and Eastern Mediterranean Region.

EVIPNet’s pragmatic efforts to directly support evidence-informed health systems have focused primarily on regional and national capacity-building activities to produce and plan the evaluation of policy briefs and secondarily on organizing and planning for the evaluation of national policy dialogues at which the policy briefs are discussed.


National Health Service National Institute for Health Research (NIHR) Health Technology Assessment Programme (NIHR HTA)

The Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. ‘Health technologies’ are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the ‘National Knowledge Service’. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. The HTA programme produces independent research about the effectiveness of different healthcare treatments and tests for those who use, manage and provide care in the NHS. It identifies the most important questions that the NHS needs the answers to by consulting widely with these groups, and commissions the research it thinks is most important.

The Health Technology Assessment (HTA) Database

The HTA Database brings together details of completed and ongoing health technology assessments (studies of the medical, social, ethical, and economic implications of healthcare interventions) from around the world. The aim of the HTA Database is to improve the quality and cost-effectiveness of health care. The HTA database is produced by the Centre for Reviews and Dissemination (CRD) at the University of York, UK. Database content is supplied by the 52 members of the International Network of Agencies for Health Technology Assessment (INAHTA) and 20 other HTA organisations around the world. Details of other on-going systematic reviews are also registered on the HTA database. All new content is checked, proof read and published on the database by the in house team at CRD. The scope for inclusion is broad, encompassing any study designated as a health technology assessment by the contributing organisation.

Records for published projects contain full bibliographic details as well as contact information for the organisation publishing the report. Contributing organisations can also provide brief details of the authors’ conclusions if they wish. Links to reports, project pages and/ or organisation websites are provided wherever possible so database users can access full details directly. The HTA database also contains brief details of ongoing HTA projects. These are updated when projects complete. This enables funders and researchers to identify work already in progress and may help reduce unintended duplication of effort.


Publications on HTA

International Journal of Technology Assessment in Health Care

Official Journal of Health Technology Assessment International. The International Journal of Technology Assessment in Health Care serves as a forum for the wide range of health policy makers and professionals interested in the economic, social, ethical, medical and public health implications of health technology. It covers the development, evaluation, diffusion and use of health technology, as well as its impact on the organization and management of health care systems and public health. In addition to general essays and research reports, regular columns on technology assessment reports and thematic sections are published. Selected issues and articles are available for free. Access to full-text through HINARI.

Corinna Sorenson, Michael Drummond, Panos Kanavos. Ensuring Value for Money in Healthcare: The Role of HTA in the European Union. 2008, 156 p.

This book provides a detailed review of the role of health technology assessment (HTA) in the European Union. It examines both method and process in the prioritization and financing of modern health care, and presents extensive case studies from Sweden, the Netherlands, Finland, France, Germany and the United Kingdom. The book examines a number of issues, with particular emphasis on the responsibility and membership of HTA bodies, assessment procedures and methods, the application of HTA evidence to decision-making, and the dissemination and implementation of findings. It aims to highlight ways to improve the HTA process in Europe by examining key challenges and identifying opportunities to support value and innovation in health care.

A comparative analysis of the role and impact of health technology assessment. 2011. 133 p.

The report was conducted by Charles Rivers Associates (CRA). „A considerable amount of effort has been put into developing best practice principles which demonstrate a degree of consensus  between academia, payers and industry. Charles River Associates (“CRA”) was asked by EFPIA, PhRMA, Medicines Australia and EuropaBio to undertake a comparative assessment of the role and impact of Health Technology Assessment (HTA) in different parts of the world. In this report, we use these principles to compare how different systems use HTA, the basis of the approach they apply, how it works in practice and the consequences for the key stakeholders.“

The objective of HTA varies significantly between countries, with some HTA processes focusing predominantly on assessing medicines in terms of their therapeutic value, while others incorporate economic factors (through an assessment of value for money and budget impact) and regional disparities. The report finds a variety of models with HTA being undertaken by independent agencies in some countries whilst in others they are conducted by committees which are part of the pricing and reimbursement decision-making process. Both methods have advantages and disadvantages. The report found that HTA remains mostly applied to pharmaceuticals, and methods applied to other technologies remain less stringent often without a specific justification for why this is the case. Similarly the report shows that resources are focused on assessing new products, with established products less likely to be reviewed.


Paul Healy, Meir P. Pugatch. Theory versus Practice: Discussing the Governance of Health Technology Assessment Systems. Stockholm Network, 2009. 63 p.

This paper examines the issue of governance of Health Technology Assessment (HTA) systems. It finds that, while there seems to be a convergence among different countries towards the HTA appraisal and review process, there are still considerable differences in the manner in which national HTA system operate as a whole. Such differences, it is argued, ultimately lead to different outcomes and outputs of national HTA systems, not least in the context of patients’ ability to access new and innovative healthcare technologies.

Marcial Velasco Garrido, Finn Børlum Kristensen, Camilla Palmhøj Nielsen, Reinhard Busse Health technology assessment and health policy-making in Europe. Current status, challenges and potential. European Observatory on Health Systems and Policies, 2008. 181 p. Available in: English (PDF), 1.2 MB and in Russian (PDF), 947.5 KB

This book reviews the relationship between health technology assessment and policy-making, and examines how to increase the contribution such research makes to policy- and decision-making processes. By communicating the value and potential of health technology assessment to a wider audience, both within and beyond decision-making and health care management, it aims ultimately to contribute to improving the health status of the population through the delivery of optimum health services.

Journal Articles

History of HTA: Int J Technol Assess Health Care. 2009 Jun Vol 25, Supplement S1

This set of studies “focuses on developments within the public sector, largely the ministries of health and HTA agencies, and occasionally the public health insurance programs in selected countries... Likewise, funding agencies, the universities, and industry play a key role in HTA as perhaps the largest funding sources for HTAs and as sponsors and organizers for many HTAs. ...Evaluative work related to HTA has been carried out in developing countries under the auspices of organizations outside of those countries, for example, by aid agencies, universities, industry, the European Union (EU), and WHO.Likewise, some countries in Eastern Europe and Latin America, and many countries in Southeast Asia are not yet part of the story. This is unfortunately the case, although some countries show a strong and growing interest in the field, and there are scattered experts and emerging interests in, for example, Turkey, Iran, India, Pakistan, Laos, and Vietnam. Russia has substantial expertise in HTA and evidence-based medicine (EBM), but no national government interest can yet be discerned.” Free full-text of the whole Supplement.

Zechmeister I, Schumacher I. The impact of HTA reports on decision making in Austria. Int J Technol Assess Health Care. 2012 Jan 11:1-8.

„Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.“

Sorenson C, Chalkidou K. Reflections on the evolution of health technology assessment in Europe. Health Econ Policy Law. 2012 Jan;7(1):25-45.

„Health technology assessment (HTA) has assumed an increasing role in health systems in recent years, with many countries establishing agencies or programmes to evaluate health technology and other interventions to inform policy decisions and clinical practice. This paper reflects upon its development and evolution in Europe over the last decade, with a focus on England, France, Germany and Sweden..„ Access to full-text through HINARI.

Glasziou P. Health technology assessment: an evidence-based medicine perspective. Med Decis Making. 2012 Jan-Feb;32(1):E20-4. Epub 2011 Oct 31.

„A challenge of health technology assessment is integrating the information from different disciplines. This talk focuses on the evidence-based medicine perspective and challenges 3 assumptions of health technology assessment: assumptions about effectiveness, assumptions about coverage by health technology assessment, and assumptions about costs being immutable. Challenging these assumptions has several implications. First is the need for better evidence on effects: both low-volume, high-cost technologies and low-cost, high-volume technologies that are ineffective drains on health care systems' resources. Second, cheap but effective technologies should be better promoted, as they can displace high-cost technologies. Finally, for effective but expensive technologies, we should work to lower the price and/or costs.“ Access to full-text through HINARI.

Luce B., et al.  EBM, HTA, and CER:  clearing the confusionMilbank Quarterly, 2010, vol. 88 no. 2, pp. 256-76

„The terms evidence-based medicine (EBM), health technology assessment (HTA), comparative effectiveness research (CER), and other related terms lack clarity and so could lead to miscommunication, confusion, and poor decision making. The objective of this article is to clarify their definitions and the relationships among key terms and concepts. In this article, we propose an organizing framework that relates these evidence terms to three basic questions regarding evidence generation, evidence synthesis, and decision making: Can it work? Does it work? Is it worth it?“

Related AIHA Resources

Evidence-based Social Work. Health Resources Digest, December 2008

Translating Medical Knowledge into Practice
Health Resources Digest,  January 2009

Clinical Practice Guidelines: Development and Imlementation.
Health Resources Digest, September 2007

Internet Resources Digest Forthcoming Topics [Provisional]

  • Telemedicine
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Compiled by Irina Ibraghimova, PhD
Library and Information Management Specialist
HealthConnect International

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