Health technology assessment across the world



Health Technology Assessment (HTA) is a policy-oriented research activity that is aiming to influence the decisions made about the coverage, use and diffusion of health technology by policymakers, health care providers, managers and patients.



Several groups perform HTA around the world. Some of them are based in universities, others are operating in arm’s length government agencies or units, and some groups work for the private sector.

The International Network of Agencies for Health Technology Assessment (INAHTA) was established in 1993 and represents an excellent source of information about HTA agencies.

INAHTA has 45 members in 23 countries (http://www.inahta.org/Members/).

Members of INAHTA across the world


North America

Canada: Montreal (AETMIS); Ottawa (CADTH); Edmonton (IHE); Toronto (MAS) Mexico: Mexico DF (CENETEC); Cuahutemoc DF (IMSS) USA: Boston (VATAP); Rockville (AHRQ)


South America

Argentina: Buenos Aires (IECS) Brazil: Brasilia (DECIT-CGATS)


Europe and Middle East

Austria: Wien (LBI ofHTA) Belgium: Brussels (KCE) Denmark: Copenhagen (DACEHTA and DSI) Finland: Helsinki (FinOHTA) France: Paris (CEDIT); St Denis La Plaine (HAS) Germany: Cologne (DAHTA@DIMDI); Cologne (IQWiG) Hungary: Budapest (HunHTA) Latvia: Riga (VSMTVA) Norway: Oslo (NOKC) Poland: Warsaw (AHTAPol) Spain: Vitoria-Gasteiz (OSTEBA); Santiago de Compostela (AVALIA-T); Madrid (UETS and AETS) ; Barcelona (CAHTA); Sevilla (AETSA) Sweden: Stockholm (SBU); Liköping (CMT) Switzerland: Bern (MTU-SFOPH) The Netherlands: Diemen (CVZ); The Hague ( GR and ZonMw). United Kingdom: Aberdeen (IAHS); Glasgow (NHS-QIS); York (CRD); Birmingham (NHSC); Southampton (NCCHTA).

Israel: Tel-Hashomer (ICTAHC)


Pacific

Australia: Canberra (MSAC); Adelaïde (AHTA); Stepney (ASERNIP-S) New-Zealand: Christchurch (NZHTA)

What kind of organizations are HTA agencies?


The budget of INAHTA members varies greatly, ranging from 0.05 mil USD to 38.9 mil USD. Their permanent staff ranges from 4 to over 100.

In a recent survey of 30 HTA agencies worldwide (24 agencies responded), Martelli et al. (2007) found that:

54% of them are governmental institutions and 83,3% are supported by central government funding;

91 % have an interface with central government and 8% with regional governments; 20% with universities; 16% with healthcare professionals and 8 % with patients’ organizations or industry.

For 71% of agencies, their decisions are not prescriptive, e.g., policymakers do not have to enforce the recommendations made in HTAs.

Close to a third of the agencies (27%) are of medium size (6-15) while 18% are of large size (31-50).

Most agencies operate with less than 1 million euros annually (29%), while 20% of them spend between 7 and 14 million euros.

Other networks of HTA agencies


There are several activities wherein one can learn more about HTA and share results and skills:

HTAi: Health Technology Assessment international is an international professional society that welcomes all those who perform HTA or use it, whether in academic institutions, health care facilities, industry, business, the voluntary sector, or government. HTAi

EuroScan: The International Information Network on New and Changing Health Technologies is a collaborative network of HTA agencies for the exchange of information on important emerging new drugs, devices, procedures, processes, and settings in health care. EuroScan

EunetHTA: European network for Health Technology Assessment (EUnetHTA) coordinates the efforts of 27 European countries including 24 Member States of the European Union in evaluating health technology in Europe. EunetHTA

SNHTA: This is the Swiss network of HTA organizations. SNHTA

WHO HEN: Health Evidence Network (HEN) is an information service primarily for public health and health care decision-makers in the European Region. WHO HEN


Several universities offer graduate courses in HTA, but there exist only a few complete master’s level programs :


University of Birmingham (UK) (MSc. Program)

The program provides both a firm grounding in the range of skills and disciplines, which are essential to health technology assessment, including study design, epidemiology and statistics, economic evaluation, systematic reviews and public health policy and it provides hands on experience of HTA production. The programme is modular and can be either full-time, part-time (over one or more years) or flexible (up to six years). In addition many of the modules can be studied as stand alone short courses for which no formal qualification is available.

HTA at University of Birmingham

University of Sheffield (UK) (MSc. Program)

The program provides a firm grounding in the range of skills and disciplines which are essential to good health services research, including study design, epidemiology and statistics, qualitative analysis, economic evaluation, systematic reviews and critical appraisal. Certificate and Diploma level qualifications are also available. The program can be taken on a full time basis over one year or on a part-time basis over two years. The part-time route is designed specifically to accommodate people with demanding full-time jobs, by requiring attendance at the University on a single fixed day per week.

HTA at University of Sheffield

The Ulysses program (International) (MSc. Program)

The Ulysses Masters program is a multidisciplinary program that is jointly delivered by four universities. The target audience is comprised of professionals who have working experience as administrators or clinicians. An intensive format has been created to allow professionals to enrol in the program. Four modules of two weeks each are held in four cities: Montréal, Barcelona, Rome and Ottawa.

The Ulysses program

CAHTA (Catalan Agency for Health Technology Assessment)

CAHTA offers training at under- and postgraduate level, as well as continuous education. Courses and lectures are given through face-to-face and on-line activities. The planning and coordination of the training are achieved by CAHTA staff, whereas a team of external part-time collaborators and HTA researchers is closely involved in teaching.

Catalan Agency for HTA


Return to the dossier on: What is HTA?

REFERENCES


Martelli et al. (2007) Health technology assessment agencies: An international overview of organizational aspects. Intl. J. of Technology Assessment in Health Care, 23(4): 414-424.

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