The impact of health technology assessments: an international comparison

Abstract

With the rising costs of health care due to an ageing population and a growing number of new and expensive technologies, an increas-ing number of countries have implemented health technology assessments (HTAs) as a means of informing the decision process based on clinical and economic evidence. In an environment where resources are scarce, HTA agencies ’ objective is to ensure access to safe and effective medicines, while managing health care expenditure in an efficient way by reimbursing clinically cost-effective treat-ments. In this discourse, pharmaceutical products are the main – but by no means the only – subjects of such appraisals. Different studies show that the impact of HTAs varies greatly across countries, even though they are assessing the same drug for the same indication.1,2,3 These differences occur because of a number of considerations, such as the national priorities of the moment, the responsibilities and membership of HTA bodies, the differences in processes and time-frames, the implementation or not of the HTA recommendations, or even the ability to engage in price negotiation.4,5 In this issue of Euro Observer we undertake an analysis of health technology appraisals conducted across six agencies with a view to better understanding the similarities and dif-ferences in the appraisal process and the rec-ommendations that follow. The agencies selected are the Common Drug Review (CDR) in Canada, the Pharmaceutical Benefits Advisory Committee (PBAC) in