Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
Int J Technol Assess Health Care. 2024 Nov 29;40(1):e64. doi: 10.1017/S0266462324000631.
Health technologies play a relevant role in environmental sustainability (ES). However, limited evidence exists on approaches and methods to integrate ES into the Health Technology Assessment (HTA).
The purpose of this study is: (i) to provide an overview of global HTA organizations' progression toward the integration of ES into HTA; (ii) to investigate various paths for this integration, highlighting obstacles, priorities, potential approaches, and methods.
Data were collected via questionnaires from organizations belonging to HTA networks, International Network of Agencies for Health Technology Assessment, and European Network for HTA. To complement the results of the survey, the authors carried out a desk analysis with strategic documents available on institutional websites.
The survey included twenty-six respondents from twenty different countries (thirty-three percent response rate). Among the study's participants, there is a notable acknowledgment of the importance of integrating ES into HTA. However, only nine organizations are actively engaged in these integration efforts, each employing unique methodologies and perspectives. There is a substantial consensus on the application of life cycle assessment, with a particular emphasis on the use of environmentally extended input-output analysis, and a stronger preference for cost-utility analysis. Nevertheless, evidence on integrating ES into HTA remains scarce. Major challenges identified include data collection difficulties and the necessity for interdisciplinary teams.
Our study represents a preliminary effort to systematize initiatives aimed at integrating ES into HTA. Further research is required to customize methods and tools for appropriately evaluating the environmental impacts of technologies. The findings suggest that achieving ES-HTA integration demands a multi-tiered, interdisciplinary approach.
健康技术在环境可持续性（ES）方面发挥着重要作用。然而，将 ES 纳入健康技术评估（HTA）的方法和途径的证据有限。
本研究的目的是：（i）概述全球 HTA 组织在将 ES 纳入 HTA 方面的进展；（ii）调查整合的各种途径，突出障碍、优先事项、潜在方法和手段。
通过问卷从属于 HTA 网络、国际卫生技术评估机构网络和欧洲卫生技术评估网络的组织收集数据。为了补充调查结果，作者对机构网站上提供的战略文件进行了桌面分析。
该调查包括来自 20 个不同国家的 26 名受访者（33%的回复率）。在研究参与者中，人们明显认识到将 ES 纳入 HTA 的重要性。然而，只有 9 个组织积极参与这些整合工作，每个组织都采用独特的方法和观点。在应用生命周期评估方面存在很大共识，特别强调使用环境扩展投入产出分析，并更倾向于成本效益分析。然而，将 ES 纳入 HTA 的证据仍然很少。确定的主要挑战包括数据收集困难和需要跨学科团队。
我们的研究代表了系统地整合 ES 纳入 HTA 的初步努力。需要进一步研究来定制适当评估技术环境影响的方法和工具。研究结果表明，实现 ES-HTA 整合需要多层次、跨学科的方法。
