Priority setting for health technology assessment - Theoretical considerations and practical approaches - A paper produced by the priority setting subgroup of the EUR ASSESS project

This report is about setting priorities for health technology assessment (HTA). HTA examines systematically the consequences of the application of health technologies (broadly defined to include any health care intervention) to support decision making in policy and practice. Only a fraction of existing health technologies have been formally evaluated, and many more appear each year. Resources for HTA are, however, limited so that priorities have to be set, whether explicitly or implicitly. The aim of setting priorities for HTA should be to identify those assessments that offer the greatest benefits in relation to their cost, and thus to maximize the benefit derived from investments in HTA. HTA is an important tool in the identification of priorities for health care, but this report is not directly concerned with the identification of priorities for health care. It is intended to help those wishing to set priorities for HTA. Various theoretical models and practical systems have been developed for setting priorities for HTA. Few, however, have been formally evaluated, and this report does not recommend any single approach. Instead, it analyzes (in chapters 2 and 3) the process of setting priorities and offers (in chapter 4) some practical guidance to help those wishing to set priorities for HTA to develop a system suited to their particular needs and circumstances. Some approaches to priority setting can involve extensive analysis and discussion. Others may involve less extensive work. This report does not make any recommendation about the amount of effort that should be devoted to priority setting. The priority setting process is analyzed in some depth, but this is to help those involved understand the process and associated principles. It is not intended to imply that detailed work on priorities will be appropriate to all programs.