Lehoux P, Ganache I, Demers-Payette O, Silva H P, Plamondon G, de Guise M
Institut National d'Excellence en Santé et Services Sociaux (INESSS), Quebec, Canada.
Department of Health Management, Evaluation and Policy, University of Montreal; Public Health Research Center (CReSP), 2021 Union Street, Suite 1200, 12th floor, Montreal, QuebecH3A 2S9, Canada.
Int J Technol Assess Health Care. 2025 Mar 3;41(1):e16. doi: 10.1017/S0266462325000121.
Though Health Technology Assessment (HTA) has steadily grown over the past decades, less attention has been paid to the way HTA may prove more responsive to the broader economic, social, and environmental challenges that health systems are facing today. In view of climate change, chronic diseases, an aging population, inequalities, and workforce issues, the HTA community's unique set of skills nonetheless holds great potential to help decision-makers strengthen many publicly funded health systems around the world.
This article adopts an integrated system-wide perspective guided by the Responsible Innovation in Health (RIH) framework to explore how the HTA community may not only adapt to the of innovation but also consider its direction.
Because RIH aims to steer innovation toward a more sustainable pathway, it can help HTA agencies anticipate decision-makers' informational needs regarding four systemic challenges: (1) equitable access; (2) workforce issues; (3) accountable policy trade-offs; and (4) environmental sustainability. We clarify how key elements of the RIH framework may be used by HTA agencies to: (1) supplement their evaluation process; (2) align their priority-setting or strategic planning activities with their health system challenges; or (3) inform the production of early HTAs, horizon scans, or reports that are broader in scope than a single technology review.
The article concludes with three practical implications that were identified by the (INESSS) (Québec, Canada) and may inspire other HTA agencies.
尽管卫生技术评估(HTA)在过去几十年中稳步发展,但对于HTA如何能更好地应对卫生系统如今面临的更广泛的经济、社会和环境挑战,人们关注较少。鉴于气候变化、慢性病、人口老龄化、不平等以及劳动力问题,HTA领域独特的技能组合仍具有巨大潜力,可帮助决策者加强全球许多公共资助的卫生系统。
本文采用以健康领域负责任创新(RIH)框架为指导的全系统综合视角,探讨HTA领域不仅如何适应创新的 ,还如何考虑其方向。
由于RIH旨在引导创新走向更可持续的路径,它可以帮助HTA机构预测决策者在四个系统性挑战方面的信息需求:(1)公平可及性;(2)劳动力问题;(3)可问责的政策权衡;(4)环境可持续性。我们阐明了RIH框架的关键要素可如何被HTA机构用于:(1)补充其评估过程;(2)使其优先事项设定或战略规划活动与卫生系统挑战保持一致;或(3)为早期HTA、前景扫描或范围比单一技术审查更广泛的报告的编制提供信息。
本文最后得出了加拿大魁北克省国家公共卫生与社会服务卓越研究所(INESSS)确定的三个实际意义,可能会启发其他HTA机构。 (注:原文中“the (INESSS)”表述不完整,可能影响准确理解)