Objective: Individuals' recollections of the number and type of health service encounters are frequently required for health economic studies. We sought to establish whether the accuracy of self-reported healthcare resource utilization is a function of the duration of the recall period and the saliency of the health service encounter.

Methods: Patient recollections of a range of community services (general practitioner visits, community midwifery visits) and hospital services (accident and emergency attendances, hospital outpatient attendances, inpatient admissions) over 4-month and 8-month time periods were obtained from women participating in a randomized controlled trial. Comparisons were made with healthcare resource utilization data extracted from medical records. Where significant differences were identified between the self-reported and medically recorded data, a multivariate linear regression model was constructed to identify the factors associated with underreporting and overreporting of healthcare resource utilization.

Results: The study revealed a tendency to underreport community service utilization, which appears to be exacerbated when the recall period is extended. A number of sociodemographic and clinical factors significantly associated with this tendency to underreport community service utilization were identified. The self-reporting of hospital service utilization over varying periods of recall was found to be more accurate.

Conclusion: It is important that economic analysts establish optimal methods for estimating resource utilization quantities within health economic analytical designs. In particular, greater emphasis should be placed on extracting information on community service utilization from medical records or routine health service information systems.

Objectives: To compare the cost-effectiveness of magnetic resonance imaging (MRI) and enteroclysis in patients with Crohn's disease (CD).

Methods: A decision analytic model was performed considering the correct diagnoses of CD and complications such as fistulas and abscesses as effects. Costs were estimated in Euro () using German fee schedules.

Results: MRI was more effective and more costly compared with enteroclysis. Incremental cost-effectiveness of MRI versus enteroclysis was 1,595 per additional correctly diagnosed patient.

Conclusions: The use of MRI in the work-up of patients with CD cannot be generally recommended from an economical perspective, but results of sensitivity analysis suggest that in patients with high prevalence of complications, MRI becomes as cost-effective as enteroclysis, which is accepted standard diagnostic imaging.

Biotechnology (BT) has implications in the diagnosis, treatment/cure and prevention of diseases. Based on BT, a wide range of advanced drugs, diagnostics and vaccines have become available and are integral part of the health care system. Many new imaging and surgical intervention techniques also have great positive impact. However, given the limited resources available, especially in developing countries, the new techniques must be prioritized for correct policy decisions. This paper presents an exercise in prioritizing diagnostics and vaccines and comparing them with other high-tech medical care, which often receive the attention and favor of decision-makers and health care providers. This involves assessing the technologies for their beneficence index. This index is derived by accumulating the ratings for seven different factors e.g., need, efficacy, additional QALY, ease of integration. The outcome of the exercise shows diagnostics and vaccines to be more beneficial than surgical procedures and imaging technologies in the Indian context. Such an exercise could form a basis for resource allocation and can be favored by incentive structures for better social benefits.

After months of hype and expectation, the draft sequence of the human genome, assembled by the International Human Genome Sequencing Consortium (6) and Celera Human Genome Assembly (1), has now been published. As a scientific achievement, unraveling the 30,000 to 40,000 protein-coding genes in the human genome has been compared with landing on the moon or splitting the atom. But, as was the case with these former events, the possibilities of the future are just on the verge of unfolding; now they have to play out in real life. One of the most promising areas, and maybe the first to play out on a large scale, is pharmacogenomics. This new discipline promises improved therapeutic efficacy and effectiveness, minimizing adverse effects, increasing safety and drug tolerance, and reducing the overall cost of disease management for the individual and society (4;5;10;13;25). But some authors have characterized the introduction of pharmacogenomics as a double-edged sword; for every benefit, there are serious moral, ethical, and philosophical issues to be considered (9). It seems increasingly evident that neither science nor technology will obstruct this development, but rather the ethical, social, and legal implications will (21). Issues concerning privacy, justice, stigmatization, discrimination, patenting, and education seem to become dominant issues (15;16;17). It is also essential to point out that pharmacogenomics will crystallize the implications of genetics to a wider public, because drugs based on pharmacogenomics will be introduced to the mass market within the next few years. This means that pharmacogenomics might very well become the best known and thus the most obvious genetically oriented topic of public debate (18).

Objective: To inform about the specifics of medical devices and the resulting consequences for health technology assessment (HTA) and to present the European industry position on this topic.

Methods: The paper is based on an intensive debate within Eucomed, the European trade association in the field of medical devices, informed by an HTA Experts Group, comprising experts from within and outside the medical device industry.

Results: Based on the specifics of medical devices, there are a number of methodologic considerations that require a tailored HTA, differing from the approach taken for, for example, pharmaceutical products. These differences have an impact on the selection of the technology, the timing of the assessment, the study design, and the patient population.

Conclusion: The European medical device industry can commit to an HTA that takes into consideration the specifics of medical technologies, which is appropriate and fair, and which is done under full participation of industry. Under these circumstances HTA can be a useful tool to support rational decision making in health care.