The following papers from the Value in Health Special Issue, Health Technology Assessment in Evidence-Based Healthcare Reimbursement Decisions Around the World: Lessons Learned [Volume 12 Issue s2, Pages S1 - S53 (June 2009)] were developed to inform the ongoing debate on the nature and role of health technology assessment (HTA). Leading academicians and practitioners from around the world offer their perspectives on HTA in their country and identify lessons learned.

The paper, “Health Technology Assessment in Evidence-Based Healthcare Reimbursement Decisions Lessons Learned from Around the World – An Overview,” contains the history, use and current models of HTA and the issues surrounding the experience of HTA around the world.

In the paper, “Health Technology Assessment and Evidence Based Medicine: What Are We Talking About?” the relationship of HTA and evidence-based medicine (EBM) is presented as well as an overview of HTA as a process, where we find countries at different stages in this process.

For the papers,

  • “Nasty or Nice? A Perspective on the Use of Health Technology Assessment in the United Kingdom”
  • “Health Technology Assessment in Canada: 20 Years Strong?”
  • “Health Technology Assessment: A Perspective from Germany”
  • “Health Technology Assessment: Reflections from the Antipodes”
  • “Health Technology Assessment in Healthcare Decision in the United States”

contributors from the United Kingdom (UK), Canada, Germany, Australia, and the United States (US) were asked to describe the healthcare organizations involved in HTA, their processes, and the use of HTA in healthcare decisions of their respective countries, and to assess their HTA processes across a range of important attributes: transparency of information and process, independence of and participation in the assessment and appraisal, use of quality-adjusted live year (QALY) thresholds, methods to deal with uncertainty, and the role of ‘real-world’ data. Contributors were asked to elicit how HTA function in practice care across a range of equity, efficiency and access dimensions, effects on patient and provider choice and access, effects on healthcare budgets and health outcomes, and the role of politics in the process. Some contributors addressed all of these attributes and practical considerations, while others only addressed those deemed relevant in their country.

While the country-specific HTA health organizations and processes presented in this Special Issue may vary, emerging from these papers is a set of common issues about the role of HTA in society, its effects on public health and access to care, its effects on innovation, and on the integrity and viability of publicly financed health care in general. HTA is a focal point of an ongoing struggle across a range of countries attempting to come to terms with expanding expenditures for healthcare, the availability of remarkable new innovations in healthcare technology, and constrained budgets. While this Special Issue will not resolve these concerns, it is hoped that by articulating, comparing and contrasting HTA systems and processes, it enriches the discourse and helps build the common ground needed to seek meaningful solutions; and that the lessons learned can inform the development of HTA in societies confronting the challenges of supporting economic growth and providing basic healthcare.

The paper, “Lessons for Health Technology Assessment: It’s Only Partly about the Evidence,” emphasizes the similarity of country-specific HTA systems and processes and presents future direction.

The last paper in this Special Issue, “Editorial: Pursing Efficiency: A Dead End for HTA?” is provided by a guest editor. Guest editors are selected by the Value in Health Editor-in-Chief to critique this Special Issue to ensure that a broad range of views are expressed.

HTA Special Issue Editors and Sponsors
Health technology assessment in evidence-based health care reimbursement decisions around the world: lessons learned. Value Health 2009;12(Suppl. 2):Si.

Health Technology Assessment in Evidence-Based Health Care Reimbursement Decisions Around the World–An Overview
Paper Citation: O’Donnell JC, Pham SV, Pashos CL, et al. Health technology assessment in evidence-based health care reimbursement decisions around the world: an overview. Value Health 2009;12(Suppl. 2):S1-5.

Health Technology Assessment and Evidence-Based Medicine: What Are We Talking About?
Paper Citation: Eddy D. Health technology assessment and evidence-based medicine: what are we talking about? Value Health 2009;12(Suppl. 2):S6-7.

Nasty or Nice? A Perspective on the Use of Health Technology Assessment in the United Kingdom
Paper Citation: Drummond M, Sorenson C. Nasty or nice? a perspective on the use of health technology assessment in the United Kingdom. Value Health 2009;12(Suppl. 2):S8-13.

Health Technology Assessment in Canada: 20 Years Strong?
Paper Citation: Menon D, Stafinski T. Health technology assessment in Canada: 20 years strong? Value Health 2009;12(Suppl. 2):S14-19.

Health Technology Assessment: A Perspective from Germany
Paper Citation: Fricke FU, Dauben HP. Health technology assessment: a perspective from Germany. Value Health 2009;12(Suppl. 2):S20-7.

Health Technology Assessment: Reflections from the Antipodes
Paper Citation: Bulfone L, Younie S, Carter R. Health technology assessment: reflections from the antipodes. Value Health 2009;12(Suppl. 2):S28-38.

Health Technology Assessment in Health-Care Decisions in the United States
Paper Citation: Sullivan SD, Watkins J, Sweet B, Ramsey SD. Health technology assessment in health-care decisions in the United States. Value Health 2009;12(Suppl. 2):S39-44.

Lessons for Health Technology Assessment: It Is Not Only about the Evidence
Paper Citation: Neumann PJ. Lessons for health technology assessment: it is not only about the evidence. Value Health 2009;12(Suppl. 2):S45-8.

Editorial: Pursuing Efficiency: A Dead End for HTA?
Paper Citation: Caro JJ. Editorial: Pursuing efficiency: a dead end for HTA? Value Health 2009;12(Suppl. 2):S49.

To see this issue on-line, go to Value in Health