Being a patient myself, I am keenly aware of the importance of having access to innovative technologies to support my lifestyle and foster improved health and well-being. And, as a former policymaker in both the UK and the EU, I also understand the enormous responsibility of the healthcare system in determining which of the newest medical technologies are the safest and most effective for patients in each health constituency.
It is difficult to remedy these demands – those of patients, health systems and policymakers. Yet, this is why health technology assessment (HTA) is increasingly being used throughout Member States to inform decisions about the safety, quality and effectiveness of medical technologies in healthcare systems. HTA, which is a scientific evaluation of a new technology for introduction into a health system, is often times a complex process which may or may not take account of all impacts a new technology may pose for patients, professionals and systems. For example, some HTAs may focus on the economic and medical impacts only, foregoing issues such as quality of life for the patient and/or social and ethical factors. This is an important distinction because if quality of life issues are not taken into account in an evaluation, this can severely limit the access a patient like myself has to an important and potentially life-changing treatment.
The experience of HTA authorities across Europe differs immensely from Member State to Member State. However, authorities with extensive experience in conducting comprehensive evaluations of a technology have best practices to share with others. To what extent these best practices and evaluations can be shared is being tested in a European Commission project known as EUnetHTA. EUnetHTA is a Joint Action funded by the Commission which is currently in its second three-year term and looks to provide added value to Member States through efficient use of resources available for HTA, the creation of a sustainable system for HTA knowledge sharing and for promotion of good practice of HTA methods and processes. EUnetHTA outcomes will likely feed into a permanent network for HTA which must be established at EU level as part of the implementation of the Patients’ Rights in Cross-border Healthcare Directive.
I believe that the EU does have a role to play in fostering the appropriate use of HTA in Member States regarding decision-making in healthcare in order to meet the often contradictory demands of patients, professionals, providers and industry within health systems. But in order to do so, the EU must encourage broader, more meaningful involvement of all stakeholders (particularly patients) in the HTA network and processes shared by the permanent network. No comprehensive evaluation can be concluded without factoring in the opinion of the user(s). Likewise, the EU must facilitate greater transparency about the methodologies undertaken in HTA evaluations and the network that will share these evaluations. Otherwise, decisions will always be questioned by stakeholders about the comprehensiveness and/or involvement of stakeholders in HTA outcomes.
The permanent network for HTA collaboration could play a significant role in supporting Member States to make innovative, effective and complimentary medical technologies available to patients, but I believe that it can only do so through more stakeholder involvement and transparency. Encouraging Member States to make appropriate, comprehensive assessments of technologies, the EU can foster greater patient confidence in the safety and value of medical technologies for prevention, early diagnosis, disease monitoring and treatment. However, stakeholders, and particularly patients like myself, must insist that we are part of HTA decisions to ensure that the patient is always the main point of consideration throughout the entire healthcare decision making process.
– John Bowis, Honorary President of Health First Europe