Expanding health technology assessment towards broader value: Ireland as a case study

Irina Kinchin*, Valerie Walshe, Charles Normand, Joanna Coast, Rachel Elliott, Thilo Kroll, Philip Kinghorn, Alexander Thompson, Rosalie Viney, David Currow, James F O'Mahony

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Healthcare innovations often represent important improvements in population welfare, but at what cost, and to whom? Health technology assessment (HTA) is a multidisciplinary process to inform resource allocation. HTA is conventionally anchored on health maximization as the only relevant output of health services. If we accept the proposition that health technologies can generate value outside the healthcare system, resource allocation decisions could be suboptimal from a societal perspective. Incorporating "broader value" in HTA as derived from social values and patient experience could provide a richer evaluative space for informing resource allocation decisions. This article considers how HTA is practiced and what its current context implies for adopting "broader value" to evaluating health technologies. Methodological challenges are highlighted, as is a future research agenda. Ireland serves as an example of a healthcare system that both has an explicit role for HTA and is evolving under a current program of reform to offer universal, single-tier access to public services. There are various ways in which HTA processes could move beyond health, including considering the processes of care delivery and/or expanding the evaluative space to some broader concept of well-being. Methods to facilitate the latter exist, but their adaptation to HTA is still emerging. We recommend a multi-stakeholder working group to develop and advance an international agenda for HTA that captures welfare/benefit beyond health.

Original languageEnglish
Article numbere26
Number of pages7
JournalInternational Journal of Technology Assessment in Health Care
Volume39
Issue number1
Early online date2 May 2023
DOIs
Publication statusE-pub ahead of print - 2 May 2023

Keywords

  • Humans
  • Ireland
  • Technology Assessment, Biomedical
  • Delivery of Health Care
  • Resource Allocation
  • Biomedical Technology

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