HTA Impact / Influence

Page index:
Conceptual Paper on the Influence of HTA
Systematic Review on the Influence of HTA
Impact framework
HTA Agencies and Decision Makers
David Hailey Award for Best Impact Story
Interview with Dr. David Hailey

Member access to additional impact resources (login required)

INAHTA Conceptual Paper on the Influence of HTA

The objectives of this paper are to provide a high level overview of concepts related to the influence of health technology assessment (HTA) that have been discussed between INAHTA members, and to give a general outline on this topic for those who are interested in HTA.  The paper draws in part on suggestions made in the table discussions at the 2012 Annual Meeting of INAHTA. Issues discussed included definition of HTA influence, methodology for its assessment, reporting and communication, use of information on HTA influence, and barriers to recording HTA influence.
INAHTA_Conceptual Paper_Influence of HTA

INAHTA Systematic Review on the Influence of HTA

This systematic review examines the published literature on the influence of HTAs on health care decisions and their outcomes, and on the methods used to measure such influence. Both full HTAs and rapid HTAs (reports that took between 1 and 6 months to prepare) were considered. This review covers the research questions: What health care decisions have been influenced by HTA, and in what ways? What methods have been used to assess HTA influence? What outcomes related to use of health technologies have been linked to HTA?
INAHTA_Systematic Review_Influence of HTA

INAHTA Impact framework

INAHTA has developed a framework for reporting. INAHTA members are requested to provide information on HTAs, for which there are some indication of impact on decisions by government at the regional, national or international level. Positive, interim and negative indications of impact are all welcome. The HTA-impact form and instructions can be downloaded below.

INAHTA HTA Impact Reporting Framework and Instructions

HTA agencies and decision makers

This document has been prepared to provide guidance on the interaction of health technology assessment agencies with the decision makers whom they inform through their assessments. The perspective taken generally reflects that of the member organizations of INAHTA, which are primarily concerned with informing decision makers in the public sector.
Download the document here

David Hailey Award for Best Impact Story

(see interview with Dr. David Hailey, below)

The INAHTA Impact Story Sharing program was started in 2015 and it has been very successful in sharing knowledge and building relationships among INAHTA members.

These stories are told in-person at the annual INAHTA Congress in a brief format (~10 minutes) in small groups.  INAHTA members come to the Congress prepared to share a story about HTA impact that their agency has experienced – what has worked well (or not so well) in achieving HTA impact with decision making or more broadly in the health system or society.  This guideline provides some idea of the scope of stories that are shared among members: INAHTA Impact Story Sharing_Guideline

A series of articles based on INAHTA member impact stories is being prepared for publication in IJTAHC in 2017.

Congratulations to the recipients of the David Hailey Award for Best Impact Story, and to the semi-finalists:

2016 David Hailey Award for Best Impact Story
Winner: INESSS, Quebec, Canada, storyteller: Michèle de Guise

Honourable mention to semi-finalists:
IQWiG, Germany, storyteller: Naomi Fujita-Rohwerder
ASERNIP-S, Australia, storyteller: David Tivey
IETS, Colombia, storyteller: Aurelio Mejía

2015 David Hailey Award for Best Impact Story
HAD-Uruguay, storyteller: Alicia Alemán
Honourable mention to semi-finalists:
SBU, Sweden, storyteller: Sophie Werkö
IETS, Colombia, storyteller: Aurelio Mejía
HIQA, Ireland, storyteller: Mairin Ryan

Interview with Dr. David Hailey

D Hailey

— Dr. David Hailey
David Hailey has been associated with INAHTA since its formation. He is a former Board member and has worked with several member agencies.   He was chair of the Working Group on Impact of HTA and has co-authored several INAHTA publications.

Interview with INAHTA Secretariat, 2016

1. The David Hailey Award for impact story sharing was established to encourage involvement of members in this aspect of HTA.  What were some of INAHTA’s previous activities related to HTA Impact?

In  2001,  Liz Adams (VATAP, USA) surveyed INAHTA members for examples of the direct impact of HTA on health policy. The results were intended as a tool for promoting the value of HTA to healthcare decision makers. The responses gave information on the types of decision that were being informed, and of action taken or influenced by decision makers.

This work provided useful input to discussion at the 2002 Annual Meeting where there was interest in information on impact of HTAs being included on the INAHTA website.  A framework for recording details of HTA impact was developed by a working group and included on the website.

There was some use of the framework for routine reporting through the website and it was useful in surveys of member agencies. These included projects on the influence of rapid HTAs, measurement of HTA influence by INAHTA members and use of HTA for disinvestment decisions.

More recently, following discussion at the 2012 AM in Bilbao, the working group completed its activities with a conceptual paper and a review of published evidence on the Influence of HTA. 

2.  So what are the reasons for assessing HTA influence?

Information on the influence of HTA products is helpful for management of an HTA program. At a basic level HTA program should know where its reports are going, if they have been understood, if there are any difficulties, and whether further work is needed.  Appraisal of short – term influence on clients should be routine.

The influence of HTA reports is an indicator of the output and performance of an HTA program. It is prudent for HTA programs to have measures of their assessments’ outcomes for the purposes of audit and review.  Demonstration of the influence of an HTA program will help to get and keep funding and resources for the organization.

Then information on the influence of assessments has a wider role in making a contribution to a broader, global perspective of HTA’s achievements and usefulness.   The stories now being presented at Annual Meetings are part of this, following on from suggestions made at Bilbao.

3.  What are some of the challenges in measuring HTA impact?

Issues to consider are resources, data, decision-makers and influence from other sources. Detailed studies of HTA influence can become significant research projects. Finding time and resources for them may difficult for agencies; there is a need to select worthwhile topics.  Availability of data can be a problem and access to records may need to be negotiated.  

The influence of an HTA program will in part be determined by the effectiveness of decision makers and other organizations. Short-term influence – after getting the message to the decision maker – is usually measurable.  After that, influence will be less certain.  There are many non – HTA influences on the administrative process used by decision makers, and on outcomes related to use of the technology that has been assessed.

4. What you see in the future for HTA impact measurement?

Longer term effects of HTA on clinical practice and health outcomes are areas that need more attention.  There may be difficulties in getting credible evidence, but there will be opportunities to document and publicise these achievements.

We suggested in the INAHTA report on the systematic review that quality registers and clinical data bases, which are growing rapidly, could be very useful tools for analysing the influence of HTAs.  It would be good to see more on the contributions of HTA to savings and cost – effective use of technologies within health systems.  As far as INAHTA is concerned, there is likely to be a focus on government – related programs and related decisions, reflecting our mandate and main clients.