Health Technology Assessment: The Scientific Career of a Policy Concept

Abstract

Objectives: The aim of this work was to provide a comprehensive overview of the evolution of the health technology assessment (HTA) concept in the scientific literature through a scientometric approach. Methods: A literature search was conducted, by selecting publications, as well as news from the media, containing "health technology assessment" in their title, abstracts, or keywords. We then undertook a bibliometric and network analysis on the corpus of 2,865 publications thus obtained. Results: Since a first publication in 1978, interest in HTA remained marginal until a turning point in the late 1980s, when growth of the number of publications took off alongside the creation of the U.K.'s NICE agency. Since then, publications have spread across several journals. The ranking of the organizations that publish such articles does not reflect any hegemonic position. However, HTA-related scientific production is strongly concentrated in Commonwealth and Nordic countries. Despite its transnational aspects, research on HTA has been framed within a small number of scientific networks and by a few opinion leaders. Conclusions: The "career" of the HTA concept may be seen as a scientific-knowledge based institutionalization of a public policy. To succeed in a country, HTA first needs scientific prerequisites, such as an organized scientific community working on the health sector and health services. Then, it appears that the recognition of this research by decision makers plays a key role in the development of the field.

The Emerging Social Science Literature on Health Technology Assessment: A Narrative Review

“…Fourth, we reviewed exclusively works in English, possibly introducing an English National Institute for Health and Care Excellence bias. Although this may well be a faithful reflection of the literature, 107 we may be perpetuating an Anglo-centric perspective on the study of HTA to the detriment of alternative views. Fifth, by juxtaposing the social scientific literature with the more established HTA policy analysis, we may have inadvertently oversimplified existing health economic scholarship.…”

A Avaliação das Tecnologias em Saúde: origem, desenvolvimento e desafios atuais. Panorama internacional e Brasil

“…Em uma perspectiva histórica, a expansão e difusão da ATS pode ser dividida em três fases: fortalecimento como campo científico (1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987), legitimação nas políticas (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002) e institucionalização e desenvolvimento internacional (2003-2013) 3 .…”

“…Desde a metade dos anos 1990, todos os sistemas de saúde dos países da Organização para Cooperação e Desenvolvimento Econômico (OCDE) e da maioria dos "países de renda média" utilizam a ATS nos processos de decisão para incorporação de tecnologias aos sistemas de saúde, com especificidades nacionais 6 . Ela foi institucionalizada por meio da criação de agências de ATS que assumiram a responsabilidade de fornecer aos gestores avaliações apoiadas em sínteses do conhecimento científico disponível sobre a eficácia, efetividade e eficiência de tecnologias oferecidas para o mercado 3 . Ocorreu importante processo de internacionalização da ATS, como pode ser observado pela criação de redes e pelo progressivo aumento do número de agências integrantes da International Network of Agencies for Health Technology Assessment (INAHTA), atualmente com 55 membros 7 .…”

Health Technology Assessment and Health Care Reimbursement in the European Union: Permissive Dissensus and the Limits of Harmonization through the Backdoor

“…As a multidisciplinary, evidence-based evaluation of the clinical, economic, social, ethical, legal, organizational, and other aspects of new health technologies, health technology assessment eventually influences reimbursement decisions in European countries. Sometimes this is done directly, as in the case of the most famous HTA body worldwide, the English National Institute for Health and Care Excellence (NICE) (Benoit and Gorry 2017), and sometimes indirectly, as in the German Institut fü r Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), which provides recommendations on the technologies' value for money to statutory health insurance funds, which are then used in price negotiations with manufacturers.…”