Health technology assessments: what do differing conclusions tell us?

BMJ 2010; 341 doi: (Published 22 October 2010) Cite this as: BMJ 2010;341:c5236
  1. Finn Børlum Kristensen, director1, adjunct professor2,
  2. Ansgar Gerhardus, researcher3
  1. 1Secretariat for European Network for Health Technology Assessment, National Board of Health, Copenhagen, Denmark
  2. 2Faculty of Health Sciences, University of Southern Denmark, J B Winsløws Vej 19, 3, DK-5000 Odense C, Denmark
  3. 3Department of Epidemiology and International Public Health, University of Bielefeld, Bielefeld, Germany
  1. Correspondence to: F B Kristensen fbk{at}
  • Accepted 10 August 2010

Analysis of national decisions on HPV vaccination shows the value of greater exchange, agreement on core methods, and increased collaboration between Europe’s health technology assessment agencies, say Finn Børlum Kristensen and Ansgar Gerhardus

Static or shrinking health budgets in Europe and elsewhere are increasing the focus on value for money. When a new drug, medical device, or procedure is introduced, policy makers and clinicians are increasingly relying on health technology assessments (HTAs) to ensure it is cost effective. For example, in England and Wales the National Institute for Health and Clinical Excellence’s (NICE) mandatory guidance on whether a new technology should be funded by the NHS is based on health technology assessments.

HTA is a multidisciplinary process that compiles, analyses, and summarises information about the medical, social, economic, and ethical issues related to the use of a health technology. It is firmly based on research and has been heavily influenced by the methods of evidence based medicine.1 Nevertheless, the conclusions of assessments of the same health technology can differ widely even when they build on the same primary studies. Differences could be due to variations in the selection or interpretation of the data or be related to country specific factors such as local context and values. Based on a comparative analysis of six assessments of vaccines against human papillomavirus, we argue for the use of a common core of information and methods to enable a structured and transparent exchange of data and knowledge between countries.

Proliferation of HTA agencies in Europe

Currently 16 European countries have national HTA agencies.2 Several countries also have regional and hospital based HTA bodies. The European agencies are members of the International Network of Agencies for Health Technology Assessment (INAHTA). Membership implies that the organisation is not for profit, relates to a regional or national government, and is funded …

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