Technology assessment in Catalonia: integrating economic appraisal

A brief description of the evolution and role of the Catalan Office for Health Technology Assessment (COHTA) into the framework of the Catalan Health Care Service are presented. Methodological approaches used by COHTA range from synthesis of scientific evidence to the collection of primary data. Regarding the integration of economic appraisal into technology assessment, the main approaches are the following: integration into clinical trials funded by the COHTA and in the reimbursement policies of the Catalan Health Service. COHTA participates in the process of purchasing medical technologies, especially expensive ones, and in the establishment of reimbursement policies of medical technologies. The particular characteristics of COHTA as a regional agency for Technology Assessment and its position into the framework of the Department of Health are discussed. Among the advantages of this position are the knowledge of the relevant questions for policy makers and the potential influence in the process. Among the disadvantages are the possibility of losing autonomy. Regional agencies that are closely related to the regional health services could provide a better understanding of the real problems in clinical practice and in the utilization of health technologies.