Health technology assessment of medical devices

esearch, civil society and mediatorshave been acknowledged as equallyimportant actors (41).The most current and importantcontribution to the advancement ofhealth research on the internationalstage is the WHO strategy on researchfor health, which was approved by theWorld Health Assembly in May 2010.The strategy focuses on the managementand organization of research activitieswithin WHO and on support provided tocountries in organizing health researchwhen required (42). Since this is such animportant piece of work it is being usedto inform the structure and approach fordeveloping country HTA capacity.11.2 Priority setting for healthtechnology assessmentMaking choices of resource allocationin health care is a complex andcontested matter. Approaches usingcost-effectiveness, QALYs, programmebudgeting marginal analysis, anddeliberative discourse are recommended.The optimal approach for priority settingin health care however is far from clear,as each technique has its own strengthsand weaknesses. A deliberative approachusing summaries of costs and benefits ofoptions as a basis for discussion may bepreferable as it is inclusive of a wide arrayof participants.A balance sheet approach has beenshown to be very promising in study ofa low-income setting. The authors of thepaper Combining evidence and valuesin priority setting: testing the balancesheet method in a low-income country(43) concluded that evidence-based anddeliberative decision-making does changepriorities significantly in an experimentalsetting. Their use of the balance sheetmethod was meant as a demonstrationproject but could, if properly developed,be feasible for health planners, expertsand health workers; although morework is needed before it can be used bylaypersons (43, 44).11.3 A strategy of healthtechnology assessment focalpointsHTA could be introduced gradually byidentifying individuals with a capacityfor accessing and understanding HTAsand making these individuals the “focalpoints” of HTA and scientific evidence ofeffectiveness of health-care interventions.Focal points could be located in anational research organization, a nationalgovernment department, a university orother non-profit agencies concernedwith advancing the use of HTA for goodgovernance in policy- and decisionmaking.These individuals – hereafterreferred to as “HTA focal points” –would serve as knowledge mobilizers orambassadors of the relevant informationthat they would bring to the attention ofpolicy- or decision-makers.The basic role of the HTA focal pointwould be to develop awareness of healthtechnology assessment and increasethe uptake and use of HTA within adesignated country by:• developing and supporting a networkof HTA stakeholders within thecountry that find HTA useful in thepolicy- and decision-making;• facilitating the flow of HTAinformation from the internationalHTA community to the country;• acting as the primary contact inthe country for HTA resources andinformation;• organizing or facilitating meetings,providing presentations andconducting workshops to helppotential users of HTA to interpretand disseminate HTA information;30Health technology assessment of medical devices