2. HTA in support of better health systems

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HTA in support of better health systems

Policy makers are concerned not only about benefits to individual patients, but to populations in general. HTA aims to assist policy decisions to improve the performance of health systems by using robust evidence-based approaches to make clear, consistent recommendations about which health technologies to use and for which patients. This supports quality improvement and efficiency of the overall health system.

In order to do this, HTA must provide reliable advice to the various decision-making levels in the health system structure. Regarding medicines, these decisions could take place at a national or regional government level, in individual institutions or hospitals, or by individual care providers. When making recommendations about medicines, the HTA body must consider whether medicines are:

  • Reimbursed in insurance-based systems.
  • Recommended for use in taxation-based systems (typically the medicine would be put on a formulary, consisting of a list including a range of medicine options that can be prescribed for a specific condition).

From a HTA perspective, the key issue in understanding health systems is distinguishing between financing and care delivery.

  • Financing: who pays for services and how money is transferred to providers. This is important because it may influence behavior of practitioners and institutions.
  • Care delivery: how healthcare is delivered to individuals from practitioners and institutions. This is important because it may affect how medicines are then used.