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Published online: 27 July 2018
© Springer Nature Switzerland AG 2018
Abstract
Health technology assessments (HTAs) are meant to inform health policy by taking account of all the potential impacts of using a health technology. In the 1990s, HTAs included rigorous research to produce patient-based evidence, and some supported participation of patient representatives to help focus HTA research and determine value. In the 2000s, HTAs became more closely linked to reimbursement decisions, focusing on clinical and cost effectiveness. Patient involvement should be tailored to the specific needs of each HTA. As the timeframe for HTAs has reduced, research to produce patient-based evidence has been replaced by input from patient groups. This places a burden on individuals and organizations that needs to be critically reviewed. Therefore, it is imperative that we clarify when patient involvement is likely to add value and support patients to provide their unique knowledge in the most optimal way to influence HTA decision making. To reduce the burden on patient groups, more must be done to encourage research to produce patient-based evidence early in technology development. Like clinical research, a programme of research should be carefully planned, with appropriate methodological rigor for each study, and all research should be published. For this, the development of quality standards for research to produce patient-based evidence may be needed. Patient involvement has inherent value. It should be focused, systematic and transparent, and evolve according to the experiences of all stakeholders. All countries or collaboratives that undertake HTA should consider how they can elicit the needs, preferences and experiences of patients to support creation of patient-centered healthcare policy.
1Is Health Technology Assessment (HTA) Compatible with Patient Centeredness?
Health systems funded by taxation, social insurance, personal/employer insurance or private fees may seem very different but they often align with the 'six pillars of quality' to deliver effective, safe, patient-centered care in an efficient, timely and equitable manner [1]. Another area of alignment is the challenge resulting from increasing demand [2] that often exceeds available healthcare resources. This requires difficult choices about who to treat, with what intervention, in what setting and for how long [3].
Health technology assessment (HTA) is a field of scientific research intended to inform policy making about a major area of expenditure...