In 2001 the OECD embarked on a three-year Health Project. The project focuses on measuring and analysing the performance of health care systems in Member countries and factors affecting performance. The purpose of the analysis is to help decision-makers formulate evidence-based policies to improve their health systems' performance.
As part of the OECD Health Project, the Biotechnology Unit (DSTI) is undertaking an analysis of the impact of new and emerging health-related technologies (NEHRT).
The primary aim of this project is to assess ways in which industrialised countries can manage health-related technological change so that it meets the goals of the health care system.
The role of health technology assessment (HTA) is at the centre of this analysis.
Health-related technology includes drugs, devices, medical and surgical procedures as well as interventions aimed at prevention and rehabilitation of disease.The definition also incorporates the organisational and support systems in which health care is provided.
The purpose of HTA is to facilitate the allocation of resources in relation to the goals of the healthcare policy maker.
HTA needs to perform two functions to facilitate this role. Firstly, it must provide policy-makers with evidence on the relative effectiveness and costs of technology (knowledge generation), and secondly it must ensure that this information is used appropriately (knowledge utilisation).
The knowledge generations functions of HTA may include:
Identifying evidence, or lack of evidence, on the benefits and costs of health care interventions.
Synthesising health research findings about the effectiveness of different health interventions.
Evaluating the economic implications and analysing cost and cost-effectiveness.
Appraising social and ethical implications of the diffusion and use of health technologies as well as their organisational implications.
The knowledge utilisation functions of HTA may include:
Dissemination of information to policy makers, providers and patients.
Facilitating practice change through various policy instruments.
Researching service, organisation and development structures, and their effects on the behaviour of providers.
Tracking, monitoring and policing of knowledge use.
Health technology has been identified as a major factor in the growth of health care expenditures in industrialised countries.The concern for policy makers is that high value technologies are sometimes adopted less rapidly than low value technologies.
More specifically, OECD countries identified the following four issues as prime concerns in relation to the assessment and diffusion of new and emerging health-related technologies:
Generating acceptance and compliance amongst health professionals and other stakeholders of HTA recommendations.
Limitations of cost-effectiveness analysis (CEA).
Handling uncertainty and risk in decision-making.
The implications arising from advances in genetics and biotechnology.
Whilst Member countries face many common issues, there is considerable variation in HTA practices and outcomes across the OECD.Such variation lends itself to an analysis of HTA performance at an international level.
There are three key phases to this project:
To develop an analytical framework by which we can assess the performance of HTA in Member countries.
Evaluate which factors deliver on Member country HTA goals (through case studies and literature reviews).Recognising that HTA performance will be shaped by the health care system in which it operates.
Draw up such principles of good practice, as we are able at an OECD level.
An expert group, drawn together from a wide range of stakeholders, including national health, industry and technology departments, academia, health technology assessors and industry, will guide the project.The expert group met on three occasions during the life of the project. A workshop was organised, it was aimed to establish principles of good practice in HTA.
The project has now been completed and the report published.
