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PERSPECTIVE: SOME CONCLUSIONS FROM MY LIFE IN HEALTH TECHNOLOGY ASSESSMENT

Published online by Cambridge University Press:  03 April 2018

Abstract

I have worked in health technology assessment (HTA) since 1975, beginning in the United States Congress Office of Technology Assessment (OTA), where we were charged with defining “medical technology assessment”. My main concern in HTA has always been efficacy of healthcare interventions. After years in OTA, I was invited to the Netherlands in 1985, where the Dutch government invited me to head a special commission concerning future healthcare technology and HTA. From there, I became involved in over forty countries, beginning in Europe and then throughout the world. My most intense involvements, outside the United States and Europe, have been in Brazil, China, and Malaysia. During these 40-plus years, I have seen HTA grow from its earliest beginnings to a worldwide force for better health care for everyone. I have also had some growing concerns, outlined in this Perspective article. Within HTA, I am most disappointed by a narrow perspective of cost-effective analysis, which tends to ignore considerations of culture, society, ethics, and organizational and legal issues. In the general environment affecting HTA and health care, I am most concerned about the need to protect the independence of HTA activities from influences of the healthcare industries.

Type
Perspective
Copyright
Copyright © Cambridge University Press 2018 

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References

REFERENCES

1.Ruffin, J, Grizzle, J, Hightower, N, et al. cooperative double-blond evaluation of gastric freezing in the treatment of duodenal ulcer. N Engl J Med. 1969;281:1619.Google Scholar
2.Cochrane, A. Effectiveness and efficiency. London; The Nuffield Provincial Hospitals Trust; 1972.Google Scholar
3.Office of Technology Assessment. Development of medical technology, opportunities for assessment. Washington, DC: U.S. Government Printing Office; 1976.Google Scholar
4.Office of Technology Assessment. The implications of cost effectiveness analysis of medical technology. Washington, DC: U.S. Government Printing Office; 1980.Google Scholar
5.Office of Technology Assessment. Strategies for medical technology assessment. Washington, DC: U.S. Government Printing Office; 1982.Google Scholar
6.Office of Technology Assessment. Assessing the efficacy and safety of medical technologies. Washington, DC: U.S. Government Printing Office; 1982.Google Scholar
7.Office of Technology Assessment. Policy implications of the computed tomography (CT) scanner. Washington, DC: U.S. Government Printing Office; 1978.Google Scholar
8.Banta, D, Thacker, S. Assessing the costs and benefits of electronic fetal monitoring. Obstet Gynecol Surv. 1979;514:627642.CrossRefGoogle Scholar
9.Banta, D, Thacker, S. Electronic fetal monitoring, lessons from a formative case of health technology assessment. Int J Health Care Technol Assess. 2002;18:762770.CrossRefGoogle ScholarPubMed
10.Banta, D, Gelijns, A. Anticipating and assessing health care technology. Dordrecht: Martinis Nijhoff Publishers; 1987.CrossRefGoogle ScholarPubMed
11.Banta, HD, Werkö, L, Cranovski, R, et al. Report from the EUR-ASSESS Project. Int J Health Care Technol Assess. 1997;13:133340.Google Scholar
12.Integrate-HTA. Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies. http://www.integrate-hta.eu/wp-content/uploads/2016/08/IPP_Guidance-INTEGRATE-HTA_Nr.3_FINAL.pdf (accessed April 2017).Google Scholar
13.EUnetHTA. HTA core model. http://www.eunethta.eu/hta-core-model (accessed April 2017).Google Scholar
14.’t Hoen, E. Private patents and public health. Diemen, the Netherlands: AMB Press; 2017.Google Scholar
15.Wild, C, Kirk, R, Perleth, M, et al. Open letter to the HTAi Board, 2014.Google Scholar
16.Wheaton, S, Paun, C. Brussels gets into drug business. Politico. https://www.politico.eu/article/brussels-to-find-out-how-much-it-can-do-on-drug-pricing/ (accessed January 17, 2018).Google Scholar