Health Technology Assessment

Health Technology Assessment

The systematic evaluation of the properties, effects, and/or impacts of a health intervention, including: medical, economic, social, legal, and ethical considerations.

Health interventions

A health intervention is any service, product, or programme to prevent, diagnose, treat or manage a health condition. For instance, a health intervention could be medication, vaccine, diagnostic test or screening programme, rehabilitation service, medical device, therapy or counselling service, medical transport, and more.

The HTA approach to health priority-setting typically involves five stages

Topic Selection

A particular health intervention is chosen for an in-depth look at the evidence so that the committee can consider if it should be included under NHI. Sometimes this happens when a new medicine is developed to see if it should be added. Other times an intervention may be selected for HTA when a civil society organisation or advocacy group identifies an unmet health need and proposes an intervention be added to the package.

Analysis

All the relevant evidence on the health intervention is gathered or generated to inform the appraisal committee discussions and recommendations. This traditionally includes an economic evaluation, such as Cost-Effectiveness Analysis, to determine how much additional health can be secured for the money spent on the intervention. Analysis can also include gathering evidence and information on other impacts and criteria that will be relevant to decision-making.

Appraisal

A committee comes together to review and discuss all the evidence and considerations about the health intervention in order to make a policy recommendation about its inclusion under NHI. The committee is not limited to “yes” or “no” recommendations. They may also advise further collection of evidence, for instance through a small pilot, or a price negotiation to make the intervention more affordable. They can also recommend a targeted approach to reach those who will benefit most while containing overall costs.

These committees often consist of persons with technical expertise in medicine, public health, health economics, epidemiology, patients’ rights, as well as lay public representatives. Broader inclusion of different stakeholder groups and disciplinary backgrounds within these committees can help advance procedural values related to participation and representation.

Decision-Making

A formal decision will be made about whether the health intervention will be covered under NHI. In some places, the recommendations from the Appraisal Committee are binding and in other places, policy-makers or payers have the power to make the ultimate decision, even if it differs from the HTA recommendation.

Implementation

The intervention is formally added to the NHI benefits package, with the corresponding funds allocated to cover and provide the service.

The SAVE-UHC Ethics Framework was designed to inform the types of evidence that are gathered in the “analysis” stage, as well as guide deliberations during “appraisals.”