OBJECTIVES: The purpose of this research is twofold: i) to provide an overview of the progress achieved by different HTA’s organizations around the world with respect to the integration of an environmental sustainability (ES) dimension; ii) to explore possible approach and methods from those identified in the literature.

METHODS: Data were collected by means of a questionnaire submitted to 67 HTA organizations based on their membership, as of October 2022, of INAHTA and EUnetHTA. The survey was developed on basis of results of a literature review and it explores at which stage of adoption the organization is about the integration of ES dimension into HTA which activities are carried out to do it and which method would be preferable to adopt.

RESULTS: The survey was completed by 21 respondents from a mix of countries: Argentina, Australia, Belgium, Canada, Finland, France, Germany, Hungary, Italy, Japan, Lithuania, Malaysia, Malta, Netherland, Spain, Sweden, England, USA. The study highlights a widespread awareness of the importance of integrating ES issues into HTA. However, the incorporation of ES issues in HTA is still at its infancy. In addition, the study reveals some hindering factors for the developing the methods and processes to address the environmental impact question in an HTA, such as the absence of scientific consensus on the emerging approaches, the scarce availability of data or difficulty in tracing data back to a specific technology.

CONCLUSIONS: The integration of ES dimension into HTA still appears to be very immature. A coordinated and shared action between the different actors in the system seems to be necessary in order to overcome the obstacles identified.