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Intro -- Table of contents -- Authors -- Foreword -- PART I: CRITICAL OVERVIEW -- 1 Health Technology Assessment and its Interface with Regulation, Policy and Management -- Introduction -- Health Technology Assessment and Regulators -- Health Technology Assessment and Health Policy Makers -- Health Technology Assessment and Health Service Managers -- Conclusions -- REFERENCES -- 2 Health Technology Assessment (HTA) and the Incentives to Innovation in the Life Cycle of a Health Technology -- Introduction -- The Meaning of Innovation -- What is Innovation in Health Technology? -- Key Decisions in the Life Cycle of Health Technologies: Do the Present Institutional Arrangements Provide Appropriate Incentives for Socially Needed Innovation? -- Options and Proposals for Using Health Technology Assessment to Assist Policy Practices Aimed at Promoting Socially Needed Innovation in Health -- Conclusions -- Recommendations -- REFERENCES -- 3 The Wisdom Tooth of Health Technology Assessment -- A New Old Science? -- Assessing the Assessments -- From Peer Review to Ceteris Paribus -- The Lurker at the Threshold -- REFERENCES -- 4 Regaining Health Technology Assessment from Oblivion: Improving and Integrating Regulation of Drugs, Medical Devices, Diagnostic Tests and Surgical Innovations -- Introduction -- Medical Devices -- Diagnostic Tests -- Surgery -- Indispensable Measures for Improving and Integrating Regulatory Reform of Drugs, Medical Devices, Diagnostic Tests and Surgical Innovations -- Acknowledgements -- REFERENCES -- PART II: ISSUES -- 5 Four Issues in Cost-Effectiveness Analysis and Health Technology Assessment: a View from the Touch-line -- Introduction -- Issue 1: Cost-Effectiveness Analysis - What Is It? -- Issue 2: How Specific, How General?.

Issue 3: Quality-adjusted Life-years Versus Disability-adjusted Life-years - Can There Be a Winner? -- Issue 4: Societal Perspective - Is There No Alternative? -- Conclusions -- Acknowledgments -- REFERENCES -- 6 Measuring QALYs for HTA and Health Policy Decision Making: Bridging the Gap Between Power and Act -- Introduction -- Quality-adjusted Life-years and Health State Utility Measurement -- First Solution: Debiasing -- Second Solution: Using Less Biased Methods -- Discussion -- Conclusions and Recommendations -- REFERENCES -- 7 What Health Technology Assessment System Do we Really Need? A Critical Review of the Current Situation of Health Technology Assessment in Five European Countries -- What is Health Technology Assessment? -- The Current Situation of the Health Technology Assessment System in Spain -- Health Technology Assessment in England/Wales, France, Germany, Sweden and Spain: Learning From One Another -- Valuable Lessons on Health Technology Assessment for the European Union: Operating as a Network of National Bodies? -- Foregone Benefits and Future Possibilities of Effectiveness Improvements on Health Technology Assessment Outcomes and Dissemination -- Conclusions -- Acknowledgements -- REFERENCES -- 8 The Final Stretch? How Shared Decision Making Extends Health Technology Assessment to Meet Patient Preference -- Introduction -- Shared Decision Making: Definitions, Origins, and Expectations -- Why Shared Decision Making Matters -- How is Shared Decision Making Relevant to Managing Innovative Technology? -- How Might Shared Decision Making Contribute to Health Technology Assessment? -- Conclusions -- REFERENCES -- 9 Dissemination of Health Technology Assessment -- Introduction -- Development of Health Technology Assessment -- Diffusion and Use of Knowledge in Healthcare -- What is the Problem? -- What Can Be Done?.

The Importance of Health Policy -- Implementation of Health Technology Assessment -- Health Technology Assessment in the Private Sector and Access to Information -- Professional Groups -- Conclusions -- REFERENCES.

This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA's features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.

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