In May this year, a new definition of HTA was announced following a collaboration co-led by the International Network of Agencies for HTA (INAHTA) and HTA International (HTAi).
This is important as it provides insight into how the members of INAHTA and HTAi, as well as the other collaborations noted, are viewing the evolution of HTA. Previously, the various groups had their own definitions, now they are moving forward with the same focus, in the same direction.
The joint task group conducted three rounds of consultation to reach a consensus. Discussion focused on whether:
- the definition of a health technology needed updating (no);
- to include improving health outcomes as an aim, in addition to informing health policy and decision making (no);
- removal of jargon and simplification (yes); and
- how to express the concept of value (considered context-related).
The change from ‘all available evidence’ to ‘best available evidence’ acknowledges that decisions must be made and pragmatism may be required.
The general nature of the definition is meant to “reflect different decision contexts in low-, middle-, and high-income countries, such as: formulary coverage or reimbursement decisions (including disinvestment); clinical practice guideline development; defining emergency kits, disaster planning, (basic) benefit packages, and essential medicine lists; medical device and equipment procurement planning; negotiating prices for health technologies, and other decision contexts at the national, regional, or local levels, including hospitals”.
HTA is a versatile tool, and even though the definition may be quite general and succinct, how it came about says a lot.
Note 1: A health technology is an intervention developed to prevent, diagnose or treat medical conditions; promote health; provide rehabilitation; or organize healthcare delivery. The intervention can be a test, device, medicine, vaccine, procedure, program, or system.
Note 2: The process is formal, systematic, and transparent, and uses state-of-the-art methods to consider the best available evidence.
Note 3: The dimensions of value for a health technology may be assessed by examining the intended and unintended consequences of using a health technology compared to existing alternatives. These dimensions often include clinical effectiveness, safety, costs and economic implications, ethical, social, cultural and legal issues, organizational and environmental aspects, as well as wider implications for the patient, relatives, caregivers, and the population. The overall value may vary depending on the perspective taken, the stakeholders involved, and the decision context.
Note 4: HTA can be applied at different points in the lifecycle of a health technology, that is, pre-market, during market approval, post-market, through to the disinvestment of a health technology.
Reference: O’Rourke B, Oortwijn W, Schuller T, the International Joint Task Group (2020). The new definition of health technology assessment: A milestone in international collaboration. International Journal of Technology Assessment in Health Care 36, 187–190. https://doi.org/10.1017/S0266462320000215