Medical Decision Making (MDM)
April 2013; 33 (3)
http://mdm.sagepub.com/content/current

Special Issue: Health Technology Assessment to Inform Policy
Editorials
Methods Development for Health Technology Assessment: Is It Time to Set Priorities?
Mark Sculpher
Med Decis Making April 2013 33: 313-315, doi:10.1177/0272989X13480564
http://mdm.sagepub.com/content/33/3/313.extract

Extract
Most health care systems internationally have to face the problem of how to allocate limited resources across interventions and programs. This is true for any collectively funded system, whether financed from general taxation, private or social insurance, or a mix of sources. In part this relates to decisions about which medical technologies to fund and, in particular, whether to devote the system’s resources to the numerous new pharmaceuticals, devices, and procedures that become available each year. Health technology assessment (HTA) offers a broad set of tools to support these types of decisions including systematic review, analysis of clinical studies and routine administrative data, health outcome measurement and valuation, and economic evaluation. Jurisdictions differ in the way they use these tools. Some systems, such as those in Germany and the public sector systems in the US, use largely clinical evidence from trials, perhaps augmented with information on the impact of technology adoption on the system’s budget. In contrast, an increasing number of systems, including those in the UK, Canada, and Australia, inform decisions by synthesizing clinical evidence more formally with data on costs and patients’ health outcomes using cost-effectiveness analysis.

Despite this variety of ways in which HTA is used to support decision making, there are common issues that the HTA research community has sought to inform. The most appropriate ways in which HTA is used to inform decisions is one such issue. For example, in this issue of Medical Decision Making, Stevens and Longson describe the process by which the National Institute for Health and Clinical Excellence (NICE) uses HTA to support decision making on new pharmaceuticals and other technologies in England and Wales and the challenges faced in using HTA for this purpose.1 Taking an international perspective, Neumann and others2 have reported on the extent to …