Involvement of Patients in Health Technology Assessment: Further Perspectives for Informing Decision-Makers

Abstract

1. Background Health technology assessment (HTA) is the systematic evaluation of properties, effects, and/or impacts of healthcare technology (including drugs, devices, procedures, and information systems). Its main purpose is to inform technology-related policymaking in healthcare, often relating to decisions on whether or how the use of health technologies should be supported. In undertaking HTA, the focus is often on organizations and individuals that have major financial or operational responsibilities for health technologies, including government agencies, the healthcare sector, health insurance, and manufacturing industries. Less attention has been given to involving patients and their caregivers in the HTA process. 1 The International Network of Agencies for Health Technology Assessment (INAHTA) is a group of organizations from 34 countries that provide advice to government decision-makers. In 2005, a survey by INAHTA found that most of its member agencies involved patients in some aspects of their programs, although not always routinely. 2 Agencies propounded that the involvement of patients offered the potential to broaden the perspective of assessments and of the advice provided to decision-makers. Perceived difficulties included issues with time constraints when projects were carried out in response to urgent requests and the need for resources for the identification and training of suitable patient representatives (both organizations and individuals). 3 These findings provided input to the establishment by Health Technology Assessment international (HTAi) for formation of an Interest Group for Patient/Citizen Involvement. The Interest Group has developed as a forum for promoting the incorporation of patients' perspectives into HTAs and engaging them in the HTA process. 4 A follow-up survey of INAHTA agencies suggested that the level of patient involvement remained relatively restricted with limited inclusion of patient perspectives in assessment reports. 5 2. Objective The current study purposed to present an overview of the current status of patient involvement in HTA and to consider issues facing HTA agencies in their provision of information to policy, administrative, and clinical decision-makers. Abstract Health technology assessment (HTA) is an evaluative process used to inform technology-related policymaking in healthcare. Interest in involving patients in the HTA process is increasing. Patients can provide additional perspectives to those of other groups that are concerned with health technology. Information on patients' perspectives is preferably obtained through reviews of published studies. Primary research approaches can be used if good quality, published evidence is unavailable. There are good examples of input from patients influencing the scope or preparation of HTA reports and subsequent consideration of these reports by decision-makers. One challenge to achieving effective patient involvement is finding suitable resources for patient organizations and HTA agencies. There is also a need for the further development of methods, for example, for use in rapid evidence reviews. HTA programs and the decision-makers they inform have to make choices about when patient input is appropriate. Such choices will include considering which questions or aspects of a technology requires such input and the expected time lines for assessment.