Barron Anthony J G, Klinger Corinna, Shah Sara Mehmood Birchall, Wright John S F
LSE Health, Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
Institute of Ethics, History and Theory of Medicine, Ludwig Maximilian's University of Munich, Lessingstr. 2, 80336 Munich, Germany.
Health Policy. 2015 Feb;119(2):137-46. doi: 10.1016/j.healthpol.2014.10.002. Epub 2014 Oct 14.
The new regulatory governance perspective has introduced several insights to the study of health technology assessment (HTA): it has broadened the scope for the analysis of HTA; it has provided a more sophisticated account of national diversity and the potential for cross-border policy learning; and, it has dissolved the distinction between HTA assessment and appraisal processes. In this paper, we undertake a qualitative study of the French process for HTA with a view to introducing a fourth insight: that the emergence and continuing function of national agencies for HTA follows a broadly evolutionary pattern in which contextual factors play an important mediating role. We demonstrate that the French process for HTA is characterised by distinctive institutions, processes and evidential requirements. Consistent with the mediating role of this divergent policy context, we argue that even initiatives for the harmonisation of national approaches to HTA are likely to meet with divergent national policy responses.
新的监管治理视角为卫生技术评估（HTA）研究带来了一些新见解：它拓宽了HTA分析的范围；对国家多样性以及跨境政策学习的潜力给出了更复杂的阐述；并且，它消除了HTA评估与评价过程之间的区别。在本文中，我们对法国的HTA流程进行了定性研究，以期引入第四个新见解：即国家HTA机构的出现及其持续发挥的作用遵循一种大致的演变模式，在此模式中，背景因素发挥着重要的中介作用。我们证明，法国的HTA流程具有独特的机构、流程和证据要求。与这种不同政策背景的中介作用相一致，我们认为，即使是协调各国HTA方法的举措也可能会遇到不同的国家政策反应。
