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The role of health technology assessment in coverage decisions on newborn screening

Published online by Cambridge University Press:  29 September 2011

Katharina E. Fischer ,
Scott D. Grosse  and
Wolf H. Rogowski
Katharina E. Fischer
Affiliation:
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management
Scott D. Grosse
Affiliation:
U.S. Centers for Disease Control and Prevention
Wolf H. Rogowski
Affiliation:
Helmholtz Zentrum München, German Research Center for Environmental Health and Ludwig–Maximilians–University
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Abstract

Objectives: The role and impact of health technology assessment (HTA) in health policy has been widely discussed. Researchers have started to analyze how decisions on coverage of new technologies are made. Although the involvement of HTA may be an indicator of a well established decision process, this hypothesis requires validation. Also, it is not known whether HTA involvement is associated with other characteristics of decision making like participation or transparency. The primary objective of this study was to develop and test statements on the association between the publication of an HTA and coverage decision making for newborn screening tests in European Union countries.

Methods: Five statements were defined on the relative role of HTA during the steps of decision processes: trigger, participation, publication, assessment, and appraisal. For this purpose, data on twenty-two decision processes in the area of newborn screening across Europe were analyzed, defined as a coverage decision for a given disorder in a specific country. Decision processes were compared by whether the decision was accompanied by the publication of an HTA report. To test differences, nonparametric statistical tests were used.

Results: The decision steps of trigger, participation and publication differed between the HTA and the non-HTA groups. No clear association between HTA and assessment methods in coverage decision making was identified.

Conclusions: It appeared that there is an association between HTA and coverage decision processes that are more explicit, inclusive, and transparent. It is unclear whether HTA is associated with formal evidence reviews and economic evaluations.

Keywords

Neonatal screeningDecision-making processesReimbursementHealth technology assessmentFourth hurdle
Type
POLICIES
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 4 , October 2011 , pp. 313 - 321
Copyright
Copyright © Cambridge University Press 2011

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Supplementary material: File

Fischer Supplementary Table 1

Supplementary Table 1. Appraisal Aspects - Test Statistics

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