The organization of health technology assessment in a European perspective

Article type
Authors
Oortwijn WJ, Banta HD, Van Beekum WT
Abstract
Introduction/Objective: Following a one-day hearing of the Dutch Parliament about Health Technology Assessment (HTA) in the Netherlands, TNO was asked to prepare a report on the field of HTA (Rathenau study). At the same time a European study was initiated by several European HTA agencies, coordinated by TNO (EUR-ASSESS). The objectives of these studies were to contribute to the organization of HTA in the Netherlands and to support coordination of HTA within Europe.

Methods: Literature review, both national and international; reviewing policy documents; collecting information on HTA activities, by written surveys and interviews; and analyzing and synthesizing the results.

Results: The results of the Rathenau study showed that the Netherlands has been one of the world leaders in developing HTA and policy development regarding HTA and efficiency. However, much remains to be done: 1) Coordination of HTA-activities is a serious problem in the Netherlands; 2) Priority-setting is not carried out effectively and models have not been worked out and implemented; 3) There is still too much emphasis on new 'big-ticket' technologies; 4) International cooperation is necessary in methodological development to assure that the results of studies can be shared; and 5) Results of HTA have not been effectively disseminated and implemented. The EUR-ASSESS project has contributed to improved methods of HTA and to the recognition that coordination of HTA within and between the different countries is still lacking, although some improvements have been made.

Discussion: The Dutch government has used the results of the Rathenau study in its policy document regarding HTA and efficiency in health care. Following from this policy document several advisory boards are initiating activities for stimulating coordination of HTA and improving efficiency of care in the Netherlands. Within Europe, the European Commission expects to address European-wide issues by supporting networks. EUR-ASSESS is, in fact, a beginning European HTA program based on this model. The goal of all these initiatives is to improve national decision-making by making available more and better HTA-information.