23 April 2008
New technologies that have a potential to impact on health services are in constant development, and adequate Health Technology Assessment (HTA) systems are needed in order to make evidence-based decisions on the benefits of new clinical tools. A recent report published by the European Observatory on Health Systems and Policies has identified areas which could lead to improvements in HTA systems; Ensuring value for money in health care: The role of health technology assessment in the European Union is based upon a review of HTA organisations and processes across Europe.
The authors concluded that improvements to HTA could be made through a number of mechanisms such as increased transparency and stakeholder involvement, assessment of existing technologies as well as new ones, assessing the timing of evaluations so that decisions can be made quicker and more effectively and the implementation of a system which allows re-evaluation of products based upon new information on clinical and health economics. Some of these recommendations are similar to those published in a report by the House of Commons Health Committee following an inquiry into NICE, the National Institute for Health and Clinical Excellence (see also NICE’s response).
Comment: The importance of the assessment of new biomedical tools and interventions is strongly supported by the PHG Foundation; one of the key strategic objectives is to promote the development of systems and policies for the proper evaluation of new technologies that arise from biomedical research, and many of our projects relate to evaluation of this kind; for example, see our work streams on the Evaluation and regulation of genetic tests and Promoting genetics in mainstream medicine.
Prompt and effective translation of emerging technologies into health service practice requires key steps of evaluation, assessment, appraisal and implementation following on from ‘bench to bedside’ research; the PHG Foundation suggests that in the UK, these stages are not optimally handled, with the Health Technology Assessment (HTA) scheme limited to evaluation and assessment, and not directly linked with policy development (see Genomic Medicine consultation response). Our aim as practitioners of public health genomics is to bridge the current gap between assessment/evaluation and clinical implementation, a gap which creates unnecessary delay at translating potentially valuable new technologies into clinical practice and better health.