A wealth of documents dealing with health technology assessment (HTA) has been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, countervailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement.
Given our social preferences, cherry-picking HTA's features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and, limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to indepth critical scrutiny.
This book disentangles these and other issues in connection with the advancement of HTA and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose.
Contents
PART I: CRITICAL OVERVIEW
CHAPTER 1
Health Technology Assessment and its Interface with Regulation, Policy and Management
Michael Drummond

CHAPTER 2
Health Technology Assessment (HTA) and the Incentives to Innovation in the Life Cycle of a Health Technology
Joan Rovira

CHAPTER 3
The Wisdom Tooth of Health Technology Assessment
Ricard Meneu

CHAPTER 4
Regaining Health Technology Assessment from Oblivion: Improving and Integrating Regulation of Drugs, Medical Devices, Diagnostic Tests and Surgical Innovations
Carlos Campillo-Artero
PART II: ISSUES
CHAPTER 5
Four Issues in Cost-Effectiveness Analysis and Health Technology Assessment: a View From the Touch-line
Anthony J. Culyer

CHAPTER 6
Measuring QALYs for HTA and Health Policy Decision Making: Bridging the Gap Between Power and ACT
José-María Abellán-Perpiñán

CHAPTER 7
What Health Technology Assessment System Do we Really Need? A Critical Review of the Current Situation of Health Technology Assessment in Five European Countries
Juan E. del Llano-Señarís

CHAPTER 8
The Final Stretch? How Shared Decision Making Extends Health Technology Assessment to Meet Patient Preference
Stuart W. Grande and Glyn Elwyn

CHAPTER 9
Dissemination of Health Technology Assessment
H. David Banta
Authors
Juan Ernesto del Llano
Dr Juan Ernesto del Llano Senarís, Physician (1981) and PhD in Medicine (1990) from Complutense University, Madrid. Specialist in Preventive Medicine and Public Health (MIR 1982 84, La Paz Hospital, Madrid). MSc in Community Health, Usher Institute, University of Edinburgh (1985-86). European Healthcare Leadership Program, INSEAD (1999-2000). Senior Management of Healthcare Institutions Program, IESE, Navarra University (2004). Advanced Health Leadership Forum, Universitat Pompeu Fabra (UPF), Barcelona and University of California, Berkeley (2005). General Director, Gaspar Casal Foundation (FGC). Academic Director and Professor of Public Health and Health Service Management, Master of Health Service Administration and Management (MADS), University Pompeu Fabra and Gaspar Casal Foundation. Associate Researcher, Centre of Health Economics Research (CRES), UPF. President, Spanish Association for Healthcare Technology Evaluation (AEETS). Associate Editor, Gestión Clínica y Sanitaria Journal. Biomedical Reviewer, National Agency for Assessment and Prospective (ANEP). Assistant Professor, National Agency of Evaluation, Quality and Accreditation (ANECA). Author of more than 50 peer-reviewed articles and twelve books.
Carlos Campillo
Dr Campillo-Artero holds a PhD in Medicine (University of Barcelona), an MPH (The Johns Hopkins University School of Public Health, Baltimore, MD, USA) and is a specialist in preventive medicine and public health. He works in clinical, health services and health policy research for the Balearic Health Service. Dr Campillo-Artero was a former staff member and current consultant of the World Health Organization (in Washington, DC), and is a current member of the Technical Committee on Clinical Safety of the Spanish Minister of Health, Social Services and Equity. Professor and tutor in several master programmes in clinical, health services evaluation and pharmacoeconomics. He is associate editor and referee of several national and international medical journals and associate researcher at the Centre for Research in Health and Economics, Pompeu Fabra University (Barcelona, Spain).