                 HTA: political and ethical perspectives Presentation to Forum on Pharmaceutical Policy in the Enlarged Europe at 7 th European Health Forum Gastein, Austria, 7 October 2004 Dr Chris Henshall President, HTAi Honorary Professor, London School of Hygiene and Tropical Medicine Group Director, Office of Science and Technology, Department of Trade and Industry, England

                 What is HTA? HTA is the scientific collection, review and synthesis of information to support informed decisions about health care Health care decisions are made by those accountable for them. Decisions involve judgements and reflect values attached to different goals and outcomes HTA does not make decisions. HTA seeks to inform decisions with science

                 Who can use HTA? Patients and clinicians, making individual treatment decisions Clinicians, managers, policy makers and politicians making decisions about the allocation of resources to or within health care, and/or the provision of treatments within institutions and systems

                 What support do individual decisions need? Information on probabilities of different outcomes –Relevant to their life and interests –Personalised for them –For all relevant treatment options Help in clarifying their goals and values Help in combining all this information in a complex decision

                 What information do systems-level decisions need? Effectiveness - in terms of all the outcomes of significance to the patient group or population served Cost-effectiveness - in relationship to alternative treatment strategies for target and other patient groups Demands/effects on system – human and other resources required to deliver it Total financial cost to the system – what costs will be driven in and out?

                 Systems-level decisions (2) Relationship to goals and priorities of system, eg –Health vs lifestyle –Vulnerable or priority groups Other ethical considerations Contribution to progress in health care Indirect effects on well-being of population, eg: employment and wealth creation in health care and other industries; effects on environment

                 How well is HTA doing? Effectiveness Cost-effectiveness Demands/effects on system Total financial cost to the system Relationship to goals and priorities of system Other ethical considerations Contribution to progress in health care Indirect effects

                 Key challenges for HTA Continuing to work with decision makers in health care industries and systems Understanding the patient perspective Putting the T (back) in HTA Addressing the system level and social and ethical dimensions Widening the skills base

                 Health Technology Assessment International The mission of HTAi is to support the development, communication, understanding and use of HTA around the world as a scientifically based means of promoting the introduction of effective innovations and the effective use of resources in health care Independent from all sectors, the Society provides a single forum for members to share and exchange state-of-the-art ideas related to the development and application of HTA

                 HTAi (continued) Annual scientific and professional meeting – addressing interests of all key constituencies Special interest groups –Networking –Web based interaction –Targeted meetings Developing general web-based resources –HTA Portal HTAi Policy Forum

                 Further information or