Technology assessment in health care: the U.S. perspective

Formal programs in medical technology assessment in the United States have become increasingly prominent in health care during the last 10 years in large part stimulated by remarkable technologic innovation, expansion in medical knowledge and increasing health care expenditures. The establishment of the Consensus Development Program of the National Institutes of Health initiated a decade of activities in technology assessment in both the public and private sectors and it was intensified by efforts to contain expenditures, particularly the Prospective Payment System. However, in spite of the wide range of evaluation activities, deficiencies remain which will have to be remedied if medical and policy decisions regarding technologies are to be made on sound bases.