1. 1 HTA bodies – organisational setup

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HTA bodies – organisational setup

In general, HTA bodies are established in rough correspondence to administrative structures for a health system.

For example:

  • Spain's health system is regionally managed and has therefore developed provincial HTA bodies.
  • France has a more centralised health system and HTA body.

Effective HTA bodies are able to ensure methodological rigour, and use multi-disciplinary inputs to produce and disseminate high-quality, policy-relevant recommendations to decision-makers within the healthcare system. This requires the HTA body to fit into the decision-making processes of the healthcare system and be adapted to the needs and the governing interests of decision-makers.

There are several possible arrangements for HTA bodies. Some examples are:

  • They are established by ministries of health (generally where governments are substantially involved in financing the healthcare system).
  • Their main source of funding is public money (direct, indirect taxation or tax-like contributions)
  • They receive a mixture of public and private funding.
  • The private sector pays service fees to the HTA organisation.
  • They are independent of government but perform HTA for governments or other clients.
  • HTA projects are initiated by organisations of health professionals.
  • HTA bodies are funded by and evolved from academia .

The key feature of any effective HTA body is its capability to support healthcare system decision makers. In a centralised healthcare system like in England, one large HTA body (like the UK National Institute for Health and Care Excellence, NICE) may be sufficient for supporting decisions. On the other hand, in de-centralised healthcare systems such as in Italy or Spain, many HTA organisations may be required. The EC study mentioned above identified fifteen countries with a singular national body and twelve which have an HTA system organisation that includes two or more national HTA bodies.

The following table, adapted from the EC study 2018, gives an overview of the organisational setup and scope of HTA bodies throughout the EU and Norway.

Table 1. HTA system organisation in EU and Norway

Organisational setup and scope of HTA bodies throughout the EU and Norway.

*Non-validated data / P&/orR: pricing and/or reimbursement