Health Technology Assessment

Last updated on Oct 20, 2024 5 min read ATS, HTA, Salut, JoAvaluo

Having a high-quality, efficient, and sustainable healthcare system involves making complex decisions (1). For instance, deciding whether to invest in a new health technology, replace one technology with another, or pay for the cost of a new drug, considering its impact on health (primarily in terms of safety and effectiveness) and the implications it may have for the healthcare system (e.g., in terms of opportunity cost) (1,2).

One of the fundamental tools used by healthcare systems worldwide to make informed decisions is health technology assessment (HTA). But what exactly is HTA? To answer this question, we must first define what a health technology is.

Thus, a health technology (HT) is “any intervention (test, device, drug, vaccine, procedure, program, or system) developed to prevent, diagnose, or treat medical conditions; promote health; provide rehabilitation; or organize the delivery of healthcare services” (3).

On the other hand, HTA has often been described as a bridge connecting the world of research with policymaking (4) and is defined as “a multidisciplinary process that uses explicit methods to determine the value of a health technology at different stages of its lifecycle. The objective is to inform decision-making to promote an equitable, efficient, and high-quality healthcare system” (5). Through this process, the expected and unexpected consequences of a health technology are evaluated in comparison to existing alternatives, considering various domains or dimensions, including: safety; clinical efficacy and effectiveness; efficiency of the health technology; ethical, social, cultural, and legal aspects; and organizational aspects (5).

HTA is generally developed by groups of experts from diverse disciplines and fields of knowledge in an interdisciplinary, rigorous, and transparent manner (6,7). Moreover, it can be conducted at the local level (e.g., by a hospital), regional level (e.g., by an assessment agency in a region or autonomous community), national level (e.g., assessments developed within the framework of RedETS), or international level (e.g., assessments carried out by various European agencies through collaborations like EUnetHTA).

In Catalonia, the main entity responsible for evaluating non-pharmaceutical health technologies is the Agency for Health Quality and Assessment of Catalonia (AQuAS), a public entity attached to the Department of Health of the Government of Catalonia, which serves public policies and has “the mission of generating relevant knowledge through evaluation and data analysis for decision-making, with the aim of contributing to improving the health of the population and the sustainability of Catalonia’s healthcare system” (8).

AQuAS is a corporate member, along with other entities (e.g., INAHTA, HTAi, CIBERESP, RICAPPS, etc.), of the Spanish Network of Agencies for Assessing National Health System Technologies and Performance, which is made up of assessment agencies or units from the Spanish state administration and autonomous communities (8) and is considered the reference body for the evaluation of non-pharmaceutical HTs at the state level. In addition to AQuAS, RedETS includes: Unidad de Asesoramiento Científico-técnico (avalia-t) del Servei Gallec de Salut; Instituto Aragonés de Ciencias de la Salud (IACS); Instituto de Salud Carlos III; Servicio de Evaluación de Tecnologías Sanitarias, Osteba; el Servicio de Evaluación y Planificiación del Servicio Canario de la Salud (SESCS); Unidad de Evaluación de Tecnologías Sanitarias de la Dirección General de Planificación Investigación y Formación de la Comunidad de Madrid (UETS); la Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA) (8,9).

At the European level, several projects and collaborative networks have been created, such as the European Network of HTA Agencies (EUnetHTA), with the aim of promoting collaboration between HTA agencies from different countries in the European Union, improving HTA-related processes, or promoting best practices in this area, among other objectives (10). It is worth noting that, from January 12, 2025, the application of Regulation (EU) 2021/2282 on health technology assessment (HTAR), which came into force on January 11, 2022, will begin (11).

Finally, at the international level, it is important to highlight the existence of the International Network of Agencies for Health Technology Assessment (INAHTA) and Health Technology Assessment International (HTAi). INAHTA is a network of 53 HTA agencies that support decision-making in healthcare systems affecting more than 1 billion people in 33 countries worldwide (12). HTAi is a global non-profit scientific and professional organization dedicated to promoting the importance and use of HTA, representing 82 organizations and over 2,500 individual members from 65 countries around the world (13).

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Bibliografia:

  1. Agència de Qualitat i Avaluació Sanitàries de Catalunya. Tecnologies sanitàries [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://aquas.gencat.cat/ca/fem/avaluacio/tecnologies-sanitaries/
  2. World Health Organization. 2015 Global survey on health technology assessment by national authorities: Main findings. 2015;1-34.
  3. HTA Glossary. health technology.
  4. World Health Organization (WHO). Health Technology Assessment [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://www.who.int/health-topics/health-technology-assessment#tab=tab_1
  5. O’Rourke B, Oortwijn W, Schuller T. The new definition of health technology assessment: A milestone in international collaboration. Value Heal. 2020;23(6):824-5.
  6. Vicente Edo, MJ., Gavín Benavent, P., Cantero Muñoz, P., Novella Arribas, B. R, Rodrigo, E., Toledo Chávarri, A., Triñanes Pego Y. Módulo 1. Evaluación de Tecnologías Sanitarias. Madrid; 2020.
  7. Consejo de la Unión Europea. Evaluación de las tecnologías sanitarias [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://www.consilium.europa.eu/es/policies/health-technology-assessment/#:~:text=La evaluación de una nueva,de una nueva tecnología sanitaria.
  8. Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS). Full de ruta de l’Agència de qualitat i Avaluació Sanitàries de Catalunya 2024-2027. Barcelona: Generalitat de Catalunya.; 2024.
  9. Red Española de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del Sistema Nacional de Salud. Quiénes somos [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://redets.sanidad.gob.es/conocenos/quienesSomos/home.htm
  10. EUnetHTA. About EUnetHTA 21 [Internet]. 2021 [citat 20 octubre 2024]. Disponible a: https://www.eunethta.eu/about-eunethta/
  11. European Commission. Implementation of the Regulation on health technology assessment. 2024.
  12. International Network of Agencies for Health Technology Assessment. INAHTA [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://www.inahta.org
  13. Health Technology Assessment International. What is HTAi? [Internet]. 2024 [citat 20 octubre 2024]. Disponible a: https://htai.org/about/
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