Presentation (CTI)

OBJECTIVES: With environmental sustainability becoming a key focus in healthcare, the first step toward meeting environmental commitments is to measure the impact of health interventions and integrate insights into decision-making frameworks. Environmental impact is a relevant domain for health technology assessment (HTA) agencies; however, there currently lacks an agreed or harmonious approach on a decision-making framework, the evidentiary standards needed to support claims of reduced environmental impact, and how decision outcomes will be influenced. This research aimed to explore the role of environmental impact within key global HTA agencies’ decision-making frameworks.
METHODS: A targeted search of national HTA agencies was conducted between January and June 2025 to identify relevant policies, position statements, or guidelines that addressed environmental impact or sustainability issues within HTA in Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Scotland, Spain, the US, and Wales. Agencies were qualitatively grouped into leadership categories (leader, follower, laggard) based on their objectives to incorporate environmental sustainability factors into their decision-making.
RESULTS: Great disparity exists between countries regarding progress with incorporating environmental evidence and considerations into formal assessments of new interventions. Canada, England, France, and the Netherlands are considered leaders as they are actively pursuing initiatives to incorporate environmental criteria into HTA methods. Australia, Denmark, Italy, Norway, Spain, the US, and Wales, categorised as followers, acknowledge the importance of environmental criteria in HTA or other sustainability strategies but are slightly further behind in turning their ambitions into actions. Germany and Scotland, categorised as laggards, have little/no formal initiatives to incorporate environmental sustainability into HTA.
CONCLUSIONS: Although progress is being made, there is no agreed standard methodology or assessment framework for considering environmental impact. Some countries have already embedded environmental evidence into formal assessment processes, offering practical models for implementation; best practices must be actively shared to build a community of practice.