OBJECTIVES: Conventional means of governing by HTA agencies appear to not always be fully fit or sufficient to assess innovative technologies. HTA agencies need to adapt to innovative medical technologies, while also relating to broader societal developments, such as a growing stress on the sustainability of healthcare systems. Whereas some of the earliest literature on HTA describes assessments of various medical technologies, in more recent years the applicability of existing HTA methodology to medical technologies is disputed in scientific literature. In this literature review, we explore different academic discourses around the role of HTA agencies in relation to medical technologies.

METHODS: We review literature on the role of HTA agencies regarding medical technologies and make use of a discourse analysis approach to explore the language in the selected literature. Discourse analysis is a useful tool for analyzing different modes of framing an issue, and for demarcating dominant ways in doing so. Through a systematic search, we identified 858 articles in academic literature. After inclusion and exclusion, we included 10% of articles. These articles were coded inductively using Atlas.Ti software.

RESULTS: We describe the different academic discourses around the role of HTA agencies regarding medical technology. We emphasize how medical technologies are framed as both similar and different from pharmaceuticals, leading to different views in the literature on if, and how, HTA is useful in governing medical technologies. We also note how these discourses have evolved over time in relation to the role of HTA agencies.

CONCLUSIONS: This study reports on the academic discourses on the role of HTA agencies regarding medical technologies, including key metaphors, key stakeholders, and key publications. We relate these discourses to broader sociopolitical trends over time, such as safety scandals in the medical technology market and changing regulations.