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HEALTH TECHNOLOGY REASSESSMENT OF NON-DRUG TECHNOLOGIES: CURRENT PRACTICES

Published online by Cambridge University Press:  14 September 2012

Laura Leggett ,
Tom W. Noseworthy ,
Mahmood Zarrabi ,
Diane Lorenzetti ,
Lloyd R. Sutherland  and
Fiona M. Clement
Laura Leggett
Affiliation:
University of Calgary; Institute of Public Health, Calgary email: lelegget@ucalgary.ca
Tom W. Noseworthy
Affiliation:
University of Calgary; Institute of Public Health, Calgary
Mahmood Zarrabi
Affiliation:
Alberta Health Services
Diane Lorenzetti
Affiliation:
University of Calgary
Lloyd R. Sutherland
Affiliation:
University of Calgary; Institute of Public Health, Calgary
Fiona M. Clement
Affiliation:
University of Calgary; Institute of Public Health, Calgary
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Abstract

Objectives: Obsolescence is a natural phase of the lifecycle of health technologies. Given increasing cost of health expenditures worldwide, health organizations have little choice but to engage in health technology reassessment (HTR); a structured, evidence-based assessment of the medical, social, ethical, and economic effects of a technology, currently used within the healthcare system, to inform optimal use of that technology in comparison to its alternatives. This research was completed to identify and summarize international HTR initiatives for non-drug technologies.

Methods: A systematic review was performed using the terms disinvestment, obsolescence, obsolete technology, ineffective, reassessment, reinvestment, reallocation, program budgeting, and marginal analysis to search PubMED, MEDLINE, EMBASE, and CINAHL until November 2011. Websites of organizations listed as members of INAHTA and HTAi were hand-searched for gray literature. Documents were excluded if they were unavailable in English, if the title/abstract was irrelevant to HTR, and/or if the document made no mention of current practices. All citations were screened in duplicate with disagreements resolved by consensus.

Results: Sixty full-text documents were reviewed and forty were included. One model for reassessment was identified; however, it has never been put into practice. Eight countries have some evidence of past or current work related to reassessment; seven have shown evidence of continued work in HTR. There is negligible focus on monitoring and implementation.

Conclusions: HTR is in its infancy. Although health technology reassessments are being conducted, there is no standardized approach. Future work should focus on developing and piloting a comprehensive methodology for completing HTR.

Keywords

Technology assessmentBiomedicalHealth services researchBiomedical technologyHealth planning
Type
MINITHEME: DISINVESTMENT
Information
International Journal of Technology Assessment in Health Care , Volume 28 , Issue 3 , July 2012 , pp. 220 - 227
Copyright
Copyright © Cambridge University Press 2012

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