Charting a Greener Future: Should Environmental Impact Factor Into HTA Evaluations?

ISSUE: Tackling the climate crisis is an international priority. Health care systems are major emitters, and whilst many national and international targets are in place, health technology assessment (HTA) has not yet been fully explored as a vehicle for change.

HTA agencies have expressed interest in capturing environmental effects, and stakeholders believe HTA actors can enable change. Various case studies and commentaries exist which propose tentative methods for including effects on the environment into HTA, but many of these highlight evidential and methodological roadblocks.

Several questions must be explored: Is it appropriate to capture environmental effects in HTA? If so, how can this be operationalised? Where does the balance of responsibility between the manufacturer and the health care system lie? What are the intended and unintended consequences of including environmental effects in HTA? And crucially, how much health gain are we willing to trade for a reduction in environmental effects?

This panel will debate the above questions, drawing on preliminary research and the panel’s experience of the methodological, operational and ethical complexities of changing the shape of traditional HTA in this way. The panel will critically appraise the likely consequences, and tackle the key issue of who really should pay for ‘green’ pharmaceuticals – health systems (and ultimately patients via reduced health gain), manufacturers, or wider stakeholders.

OVERVIEW: Following a brief introduction to the issues by the moderator (4 mins), the panel will debate the future of sustainability within value assessment, including scope, methods and evidence. Panellists will each speak for 12 minutes, providing their perspectives on the future of environmental impacts and HTA, including appropriateness, methods, and how to overcome the challenges. 20 minutes will be reserved for audience discussion.