Health Technology Assessment: How patients can be involved?

Health technology assessment (HTA) is the systematic evaluation of the properties and effects of a health technology to inform policy at national, regional or hospital level[1]. It is an area that ideally should involve patients’ perspectives but in reality there is still a long way to go. 

Any new or existing technology or intervention in the healthcare sector (systems, devices, pharmaceutical products, procedures) should be evaluated to determine the medical, social, economic and ethical issues associated with its use. In simple terms, such complex assessment seeks to define if the new intervention will add value to the health system, this is called Health Technology Assessment or HTA.

Patients are the ultimate users of health technologies; as such we have a crucial role in the assessment process. We can report on benefits gained as well as on adverse or unwanted effects from the use of such technologies.

More generally, patients live with their disease everyday which makes us experts in  our condition, not only in clinical terms but also from the psychological and social point of view. We can for instance provide testimonials  of the impact of a treatment on our quality of life, including ability to work, frequency of hospitalisation or medical visits, user-friendliness of tools and services.  

Such feedback can make a difference and would help policy-makers consider all aspects and implications before validating investments in a specific technology.

Karen Facey, HTA expert, and representative of the HTAi subgroup on patient and citizens involvement identified two main ways of involving patients in HTA. The first one consists in providing quantitative (through surveys and health records) and qualitative evidence (patients stories and testimonies).

In the second one, patients could also be directly involved at the design stage, before the HTA processes actually start. Patient organisations can ensure studies match patient needs and even provide some topics ideas.

Patients' perspective has a long way to go before it is fully integrated in HTA consultations and assessment processes, but at this stage some improvements have been achieved. One of these is the involvement of EPF as representative of the patient stakeholder group in EUnetHTA (European Network for HTA Joint Action 2) and in the HTA Network. The first one was established to create a sustainable network for HTA across Europe. Our role is to represent the whole patient community on transversal topics such as ethics or methodology and to channel consultations on specific diseases to the appropriate patient organisations. The latter is the political body and strategic driving force of EUnetHTA. In this context we play the role of observer on behalf of the patient stakeholder group and contribute to broader and strategic HTA-related issues. 

Some links for more information:

• www.htai.org/webinars/pcisg-intro-hta/
• www.eu-patient.eu/globalassets/projects/hta/hta-epf-final-report2013.pdf (PDF)
• www.htai.org/interest-groups/patient-and-citizen-involvement/resources/for-patients-and-patient-groups.html

Contact: Valentina Strammiello, Programme Officer, valentina.strammiello@eu-patient.eu.