Health technology assessment (HTA): ethical aspects

Sacchini, Darío; Virdis, Andrea; Refolo, Pietro; Pennacchini, Maddalena; Paula, Ignacio Carrasco de

doi:10.1007/s11019-009-9206-y

Cited by 26 publications

(16 citation statements)

References 12 publications

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“…Ethical analysis was performed by means of the so-called ‘triangular model’, a well-recognized regulatory approach 11 . This model places the human being at the centre of the ethical reflection and of the judgement of lawfulness/unlawfulness.…”

Section: Methodsmentioning

confidence: 99%

Adjuvanted influenza vaccine for the Italian elderly in the 2018/19 season: an updated health technology assessment

Waure

Boccalini

Bonanni

et al. 2019

European Journal of Public Health

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Background The elderly, defined here as subjects aged ≥ 65 years, are among at-risk subjects for whom annual influenza vaccination is recommended. For the 2018/19 season, three vaccine types are available for the elderly in Italy: trivalent inactivated vaccine (TIV), adjuvanted TIV (aTIV) and quadrivalent inactivated vaccines (QIV). No health technology assessment (HTA) of seasonal influenza vaccination in the elderly has previously been conducted in Italy. Methods An HTA was conducted in 2017 to analyze the burden of influenza illness, the characteristics, efficacy, safety and cost-effectiveness of available vaccines and the related organizational and ethical implications. This was then contextualized to the 2018/19 influenza season. Comprehensive literature reviews/analyses were performed and a static mathematical model developed in order to address the above issues. Results In Italy, influenza is usually less common in the elderly than in other age-classes, but the burden of disease is the highest; >10% of infected elderly subjects develop complications, and about 90% of all influenza-related deaths occur in this age-class. All available vaccines are effective, safe and acceptable from an ethical standpoint. However, aTIV has proved more immunogenic and effective in the elderly. Furthermore, from the third payer’s perspective, aTIV is highly cost-effective and cost-saving in comparison with TIV and QIV, respectively. Nevertheless, vaccination coverage needs to be improved. Conclusions According to this HTA, aTIV appeared the vaccine of choice in the elderly. HTA should be reapplied whenever new relevant data become available.

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Section: Methodsmentioning

confidence: 99%

Adjuvanted influenza vaccine for the Italian elderly in the 2018/19 season: an updated health technology assessment

Waure

Boccalini

Bonanni

et al. 2019

European Journal of Public Health

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“…Experts in this area convened over a 2-day period in Edmonton (October [18][19]2013) and in Cologne (October [25][26]2013), to discuss issues around quality assessment of ethics analyses for HTA (24). The workshops included thirty-two participants from ten countries: Australia, Canada, Germany, Norway, Spain, Sweden, United Kingdom, Italy, France, and The Netherlands.…”

Section: Soliciting the Views Of Experts In Methodology In Ethics Formentioning

confidence: 99%

Quality Assessment of Ethics Analyses for Health Technology Asssessment

Scott

Bond

Gutiérrez-Ibarluzea

et al. 2016

Int J Technol Assess Health Care

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Objectives: Although consideration of ethical issues is recognized as a crucial part of health technology assessment, ethics analysis for HTA is generally perceived as methodologically underdeveloped in comparison to other HTA domains. The aim of our study is (i) to verify existing tools for quality assessment of ethics analyses for HTA, (ii) to consider some arguments for and against the need for quality assessment tools for ethics analyses for HTA, and (iii) to propose a preliminary set of criteria that could be used for assessing the quality of ethics analyses for HTA. Methods: We systematically reviewed the literature, reviewed HTA organizations' Web sites, and solicited views from thirty-two experts in the field of ethics for HTA. Results: The database and HTA agency Web site searches yielded 420 references (413 from databases, seven from HTA Web sites). No formal instruments for assessing the quality of ethics analyses for HTA purposes were identified. Thirty-two experts in the field of ethics for HTA from ten countries, who were brought together at two workshops held in Edmonton (Canada) and Cologne (Germany) confirmed the findings from the literature. Conclusions: Generating a quality assessment tool for ethics analyses in HTA would confer considerable benefits, including methodological alignment with other areas of HTA, increase in transparency and transferability of ethics analyses, and provision of common language between the various participants in the HTA process. We propose key characteristics of quality assessment tools for this purpose, which can be applied to ethics analyses for HTA purposes. Keywords: Health technology assessment, Ethics analysis, Quality assessment, Methods ETHICS AND HTAThe aim of health technology assessment (HTA) is to provide decision makers with a sound evidence base for health policy decisions, including those on public reimbursement of-or disinvestment from-particular health technologies, screening programs, and changes in clinical guidelines (1-7). Toward that aim, HTA studies the "medical, economic, social, and ethical implications of the development, diffusion, and use of health technologies"-such as pharmaceuticals, medical devices, andThe authors thank Nazila Assasi and her co-authors for sharing the details of their search methodology, as well as the anonymous peer reviewers for their helpful comments and feedback. This study builds on the discussions held at the "Workshops on Methodology in Ethics for Health Technology Assessments," which were held in October 2013 in Edmonton and Cologne. The authors gratefully acknowledge the participation and contributions of all of the workshops' participants. The workshops attracted funding and in-kind contributions from:

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“…While it is recognised that such technology assessments should include ethical reflection, the role of that ethical reflection depends on the problem situation (Decker, 2004). Further, the need for ethical enquiry remains a methodological and conceptual challenge in the HTA field (Reuzel et al, 2004), while the integration of ethical dimensions into HTA reports remains limited (Sacchini et al, 2009). …”

Section: Ethical Assessment Of New Technologies: a Meta-methodology Imentioning

confidence: 99%

Ethical assessment of new technologies: a meta‐methodology

Harris¹,

Jennings

Pullinger³

et al. 2011

Journal of Information, Communication and Ethics in Society

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PurposeThe purpose of this paper is to set out a structured meta‐methodology, named DIODE, for the ethical assessment of new and emerging technologies. DIODE has been designed by a mixture of academics, governmental people and commercial practitioners. It is designed to help diverse organisations and individuals conduct ethical assessments of new and emerging technologies.Design/methodology/approachA framework discussion paper was developed for consultation to ensure that DIODE addresses fundamental ethical concerns, has appropriate and manageable scope and is comprehensive in its ethical compass. The resulting DIODE meta‐methodology uses flowcharts and templates, encompassing the use of diverse tools and techniques.FindingsThere are two different angles for the ethical assessment of new technologies; a strategic/abstract angle and a project/application specific angle. DIODE includes two channels to accommodate this distinction. Early stage testing yielded positive feedback and mostly favourable comment. Additional guidance materials are being developed in response to the feedback.Practical implicationsWithout training and guidance, it is difficult for technologists to take ethical concerns into account during the development and deployment of new technologies. DIODE can provide that training and guidance through a practical meta‐methodology which should help ICT professionals, policy makers and academics.Originality/valueThere is very little structured methodology material available on the ethical assessment of new technologies. The depth and sophistication contained in DIODE is therefore believed to be unique. DIODE provides practical help while remaining rooted in the philosophical and theoretical concepts of ethics.

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Health technology assessment (HTA): ethical aspects

Cited by 26 publications

References 12 publications

Adjuvanted influenza vaccine for the Italian elderly in the 2018/19 season: an updated health technology assessment

Adjuvanted influenza vaccine for the Italian elderly in the 2018/19 season: an updated health technology assessment

Quality Assessment of Ethics Analyses for Health Technology Asssessment

Ethical assessment of new technologies: a meta‐methodology

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