How do new technologies get into practice

Management of health technologies: an international view

BMJ 1999; 319 doi: 10.1136/bmj.319.7220.1293 (Published 13 November 1999)
Cite this as: BMJ 1999;319:1293

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  1. Egon Jonsson, director (management@sbu.se)a,
  2. David Banta, senior researcherb
  1. a Swedish Council on Technology Assessment in Health Care, Tyrgatan 7, Box 5650, 114 86 Stockholm, Sweden
  2. b TNO Prevention and Health, Public Health, PO Box 2215, 2301 CE Leiden, Netherlands
  1. Correspondence to: E Jonsson

    Technology means applied science. Health technology is defined as the drugs, devices, and medical and surgical procedures used in the prevention, diagnosis, treatment, and rehabilitation of disease.1

    Many countries regulate pharmaceuticals and medical devices and equipment by law. This legislation concerns safety and efficacy—that is, that the risk of a technology is acceptable and that it actually does what it is supposed to do. For all other technologies, such as medical and surgical procedures, there are generally no regulations.

    Summary points

    Health technology includes not only equipment, pharmaceuticals, and medical devices but also surgical and medical procedures

    Most countries regulate drugs and devices by law, by payment, or by placement of services—a new, multidisciplinary research called health technology assessment assists policy makers on matters of the medical, economic, social, and ethical implications of the dissemination and use of health technology

    Health technology assessment synthesises the findings from clinical research and includes analysis of costs, cost effectiveness, and broader social aspects of health technology

    Most countries in the European Union have established agencies for health technology assessment to provide evidence based information to health policymakers

    The development of a variety of health technologies, including effective diagnostic devices (for example, radiography, computed tomography), effective pharmaceuticals (for example, antibiotics), and other interventions, represents major improvements in the history of medicine—not long ago there was little to offer patients in the way of effective health care. Until recently almost any health technology was welcome both for scientific achievements and as potential solutions to diseases.2 Many technologies, however, have not turned out to be important advances. On the contrary, some have the potential for doing more harm than good—for example, mass screening for prostate cancer and all the treatments used to immobilise patients with back pain.3

    The rapid development of new and costly, although …

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