Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-24T19:32:58.014Z Has data issue: false hasContentIssue false

Priority setting for health technology assessments: A systematic review of current practical approaches

Published online by Cambridge University Press:  19 June 2007

Hussein Z. Noorani
Affiliation:
Canadian Agency for Drugs and Technologies in Health
Donald R. Husereau
Affiliation:
Canadian Agency for Drugs and Technologies in Health
Rhonda Boudreau
Affiliation:
Canadian Agency for Drugs and Technologies in Health
Becky Skidmore
Affiliation:
Society of Obstetricians and Gynaecologists of Canada

Abstract

Objectives: This study sought to identify and compare various practical and current approaches of health technology assessment (HTA) priority setting.

Methods: A literature search was performed across PubMed, MEDLINE, EMBASE, BIOSIS, and Cochrane. Given an earlier review conducted by European agencies (EUR-ASSESS project), the search was limited to literature indexed from 1996 onward. We also searched Web sites of HTA agencies as well as HTAi and ISTAHC conference abstracts. Agency representatives were contacted for information about their priority-setting processes. Reports on practical approaches selected through these sources were identified independently by two reviewers.

Results: A total of twelve current priority-setting frameworks from eleven agencies were identified. Ten countries were represented: Canada, Denmark, England, Hungary, Israel, Scotland, Spain, Sweden, The Netherlands, and United States. Fifty-nine unique HTA priority-setting criteria were divided into eleven categories (alternatives; budget impact; clinical impact; controversial nature of proposed technology; disease burden; economic impact; ethical, legal, or psychosocial implications; evidence; interest; timeliness of review; variation in rates of use). Differences across HTA agencies were found regarding procedures for categorizing, scoring, and weighing of policy criteria.

Conclusions: Variability exists in the methods for priority setting of health technology assessment across HTA agencies. Quantitative rating methods and consideration of cost benefit for priority setting were seldom used. These study results will assist HTA agencies that are re-visiting or developing their prioritization methods.

Type
GENERAL ESSAYS
Copyright
© 2007 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agence d'évaluation des technologies et des modes d'interven- tion en santé 2006. Selection of assessment topics. Montreal: Agence d'évaluation des technologies et des modes d'intervention en santé; Available at: http://www.aetmis.gouv.qc.ca/site/index.php?en_evaluation_selection. Accessed 11 March 2006.
Agency for Healthcare Research and Quality. 2005. EPC topic nomination and selection. Rockville, MD: Agency for Healthcare Research and Quality; Accessed 11 March 2006.
Banta DH, Andreasen PB. 1990 The politcal dimension in health care technology assessment programs. Int J Technol Assess Health Care. 6: 115123.Google Scholar
Basque Office for Health Technology Assessment. 1996. The prioritisation of evaluation topics of health: Report. Donostia-San Sebastian: Osteba;
Borowski H. Alberta health technologies decision process: Selecting technologies for provincial review [oral presentation]. CCOHTA Invitational Symposium; 25 April 2005; Ottawa. Accessed 11 March 2006.
Borowski H. 2005 The Alberta health technologies decision process: A structure and process under development - early lessons [abstract]. Ital J Public Health. 2: 77.Google Scholar
Carlsson P. 2004 Health technology assessment and priority setting for health policy in Sweden. Int J Technol Assess Health Care. 20: 4454.Google Scholar
Chase D, Milne R, Stein K, Stevens A. 2000 What are the relative merits of the sources used to identify potential research priorities for the NHS HTA programme? Int J Technol Assess Health Care. 16: 743750.Google Scholar
Davies L, Drummond M, Papanikolaou P. 2000 Prioritizing investments in health technology assessment. Can we assess potential value for money? Int J Technol Assess Health Care. 16: 7391.Google Scholar
Donaldson MS, Sox HC. 1992. Setting priorities for health technology assessment: A model process. Washington, DC: National Academy Press;
Douw K, Vondeling H. 2006 Selection of new health technologies for assessment aimed at informing decision making: A survey among horizon scanning systems. Int J Technol Assess Health Care. 22: 177183.Google Scholar
Eddy DM. 1989 Selecting technologies for assessment. Int J Technol Assess Health Care. 5: 485501.Google Scholar
Garcia-Altes A, Ondategui-Parra S, Neumann PJ. 2004 Cross-national comparison of technology assessment processes. Int J Technol Assess Health Care. 20: 300310.Google Scholar
Gulácsi L, Boncz I, Drummond M. 2004 Issues for countries considering introducing the “fourth hurdle”: The case of Hungary. Int J Technol Assess Health Care. 20: 337341.Google Scholar
Hagenfeldt K, Asua J, Bellucci S, et al. 2002 Systems for routine information sharing in HTA. Working group 2 report. Int J Technol Assess Health Care. 18: 273320.Google Scholar
Harper G, Townsend J, Buxton M. 1998 The preliminary economic evaluation of health technologies for the prioritization of health technology assessments. A discussion. Int J Technol Assess Health Care. 14: 652662.Google Scholar
Henshall C, Oortwijn W, Stevens A, Granados A, Banta D. 1997 Priority setting for health technology assessment. Theoretical considerations and practical approaches. A paper produced by the Priority Setting Subgroup of the EUR-ASSESS Project. Int J Technol Assess Health Care. 13: 144185.Google Scholar
Kohli H, Hutchens D. Here's a good idea for a health technology assessment…: An analysis of health technology assessment topics proposed to the Health Technology Board for Scotland [abstract]. In: ISTAHC 2003. Improving outcomes through health technology assessment. Abstracts. 22 June 2003. p. 51.
Lara ME, Goodman C, editors. 1990. National priorities for the assessment of clinical conditions and medical technologies: Report of a pilot study [IOM Publication 89-14]. Washington: National Academy Press;
Medical Advisory Secretariat 2006 The application process Toronto: Medical Advisory Secretariat; Available at: http://www.health.gov.on.ca/english/providers/program/mas/application/app_mn.html. Accessed 11 March 2006.
NIHR Health Technology Assessment programme. 2006 Prioritising research. Southampton, UK: National Coordinating Centre for Health Technology Assessment;.
Noorani H Boudreau R Skidmore B Husereau D.Development of a new prioritization method for health technology assessment [oral presentation]. Melbourne. Abstract available at: http://www.cochrane.org/colloquia/abstracts/melbourne/P-089.htm. Accessed 22 October 2005.
Oliver S, Milne R, Bradburn J, et al. 2001 Involving consumers in a needs-led research programme: A pilot project. Health Expect. 4: 1828.Google Scholar
Oortwijn W, Banta D, Vondeling H, Bouter L. 1999 Identification and priority setting for health technology assessment in The Netherlands: Actors and activities. Health Policy. 47: 241253.Google Scholar
Oortwijn WJ, Vondeling H, Bouter L. 1998 The use of societal criteria in priority setting for health technology assessment in The Netherlands. Initial experiences and future challenges. Int J Technol Assess Health Care. 14: 226236.Google Scholar
Oortwijn W Vondeling H van Barneveld T van Vugt C Bouter L. Priority setting for HTA in The Netherlands [abstract]. 16th Annual Meeting of the International Society of Technology Assessment in Health Care; 18 June 2000; The Hague.
Oortwijn WJ, Vondeling H, van Barneveld T, van Vugt C, Bouter LM. 2002 Priority setting for health technology assessment in The Netherlands: Principles and practice. Health Policy. 62: 227242.Google Scholar
Phelps CE, Parente ST. 1990 Priority setting in medical technology and medical practice assessment. Med Care. 28: 703723.Google Scholar
Royle J, Oliver S. 2004 Consumer involvement in the health technology assessment program. Int J Technol Assess Health Care. 20: 493497.Google Scholar
Shani S, Siebzehner MI, Luxenburg O, Shemer J. 2000 Setting priorities for the adoption of health technologies on a national level—The Israeli experience. Health Policy. 54: 169185.Google Scholar
Stevens A, Milne R. 2004 Health technology assessment in England and Wales. Int J Technol Assess Health Care. 20: 1124.Google Scholar
Townsend J, Buxton M, Harper G. 2003 Prioritisation of health technology assessment. The PATHS model: Methods and case studies. Health Technol Assess. 7: 194.Google Scholar