Health technology assessment and public health: a commentary

Area of Science:

• Public Health
• Health Technology Assessment (HTA)

Background:

• HTA development in France, The Netherlands, Sweden, and the United Kingdom is reviewed.
• Current HTA practices predominantly assess individual clinical care over population health optimization.
• Public health issues are often overlooked due to their complexity, multisectoral nature, and perceived lack of need for evaluation.

Purpose of the Study:

• To review HTA developments in select European countries concerning public health.
• To highlight the imbalance between clinical care assessment and public health evaluation.
• To advocate for a shift in HTA priorities towards public health measures.

Main Methods:

• Review of Health Technology Assessment (HTA) developments.
• Comparative analysis across four countries: France, The Netherlands, Sweden, and the United Kingdom.
• Examination of assessment priorities in relation to public health.

Main Results:

• The majority of HTA assessments focus on individual clinical services, not population health.
• Public health issues like smoking, substance misuse, nutrition, and health inequalities are under-evaluated.
• The complexity and political nature of public health challenges hinder their inclusion in HTA.

Conclusions:

• Major advances in population health status are unlikely without increased emphasis on public health HTA.
• Future HTA should incorporate broader public health issues such as smoking, nutrition, and health inequalities.
• A change in HTA priority-setting methods is necessary to include measures that improve overall health status, not just clinical services.