Policy making and roles of health technology assessment.

The processes of policy development and implementation in the public sector are complex and dynamic as several actors with different interests are involved. To pursue their benefits, these individual and organizational participants compete with each other and those with a relatively high degree of power can lead the policy decisions. Results of and recommendations derived from economic evaluation and other forms ofhealth technology assessment (HTA) are expected to have an important role in policy making and professional practice. However, it appears that on many occasions, such scientific evidence is neglected. Complex calculations, arbitrary assumptions, debatable choices of whose perspectives to pursue, difficult-to-understand methods, research designs and underlying philosophy/concepts, and time-consuming processes are claimed as key factors discouraging policy makers and practitioners from making use of HTA findings. Ethical considerations and the perception that HTA-based clinical guidelines undermine professional autonomy are also crucial.