HTA Harmonization

Health technology assessment (HTA) plays an essential role in modern health care by supporting evidence-based decision making in health care policy and practice.

Differences in the content and application of HTA have raised the question of whether or not some degree of harmonization of HTA between various jurisdictions and countries would be worthwhile. The improvement of efficiencies across assessment agencies by avoiding unnecessary duplication of effort has been a recurring theme.1

Information from HTAs can be categorized into three areas: clinical effectiveness, cost-effectiveness, and health system delivery impacts, such as ethical, psychosocial, and legal issues. Clinical-effectiveness evidence is generally considered to be the most context-free, while economic aspects of HTA are more context-specific. Ethical, legal, or psychosocial aspects of HTA appear until recently to have received less attention in individual reports, making judgment on the scope for harmonization of these elements more difficult.1

CADTH has fostered coordination and harmonization of HTA activities across multiple jurisdictions in Canada through numerous ventures. CADTH’s health economic guidelines and the Health Technology Analysis Exchange are examples of CADTH’s commitment to embracing harmonization efforts. These initiatives provide guidance for analysts and support information-sharing, the coordination and leveraging of resources for HTA work, and continuous quality improvements in the production and use of evidence-based information.

International harmonization initiatives are also underway. The European network for Health Technology Assessment (EUnetHTA) has developed an HTA tool kit to assist local health systems and support countries with limited HTA experience.

The International Network of Agencies for Health Technology Assessment (INAHTA) has a variety of initiatives that facilitate exchange and collaboration among agencies. One initiative involves the development of frameworks and methods to improve the quality of HTA reports within INAHTA (including a manual on handling ethical issues in HTA).

The International Society for Pharmacoeconomics and Outcomes Research is working towards a priority list for the development of good research practices for use in health technology assessment and health care reimbursement policies, including transferring economic data and analyses across jurisdictions.

References

  • 1. Hutton J, et al. Int J Technol Assess Health Care. 2008;24(4):511-7.

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