Review. Approaches for Health Technology Assessment in Europe: Situational Analysis

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Health technology assessment (HTA) isaprocess, which should answer the question“Isagiven health technology/medication worth its price for the value it provides?” In the spirit of the amendments to the Bulgarian Health Insurance Act and institutionalization of HTA, our team prepared this situational evaluation aiming to throw light on the practices and approaches to HTAin European countries. As awhole,we can identify two types of agencies that perform it: those servicing the population of an entire nation oraregion, and those working at the level of hospitals oranetwork of hospitals. All the agencies studied have two common characteristics. First, they were created withanon-profit purpose and second, all of them are financed by public funds inavariety of ways. It also becomes clear from the comparative analysis performed that the ways HTAis conducted in Europe differ from country to country. Irrespective of the variations, the common aspiration is that the value forapatient, to which the approved health technologies contribute, should be greater than the price to be paid for them. Bulgaria is may be the last EUstate to implement HTAin its domestic legislation and this also gives the advantage of having and using the experience of the other countries. Establishing an independent structure, which is appointed to prepare local health technologies assessment would result in transparent decision-making, participation of all concerned parties and optimization of the budget for medicines regarding the effectiveness/benefit ratio, as well as expenses.

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  • 1.[Internet]. New York: International Network of Agencies for Health Technology Assessment; 2013 [updated 2014 Sep; cited 2016 Oct1 0 ] . Availablefrom:

  • 2.[Internet]. Montreal: HTA Glossary; 2013 [updated 2013 Jul; cited 2015]. Available from:

  • 3. EUnet[Internet]. Rome: European network for Health Technology Assessment; 2014 [updated 2015 Мay; cited 2015]. Available from:

  • 4. Battista RN. Towardsaparadigm for technology assessment. The scientific basis of health services. BMJGlob Health. 1996;312(7036):11-8.

  • 5. Menon D Marshal D. The internationalization of health technology assessment. Int JTechnol Assess Health Care. 1996;12(1):45-51.

  • 6. Goodman CS. Introduction to health technology assessment. Bethesda (MD): National Library of Medicine (US); 2004.

  • 7. Brooks H Bowers R. The assessment of technology. Science. 1970;222(2):13-20.

  • 8. Daddario EQ. Statement US Congress House of Representatives Committee on Science and Astronautics. Technology assessment. Subcommittee on Science Research and Development. Washington: 90th Congress 1st session (1967). p. 9-13.

  • 9.[Internet].Washington (DC):Office of technology assessment legacy; 2014 [updated 2014 Oct; cited 2015 Jan]. Available from:

  • 10.[Internet]. New York: Office of technology assessment legacy; 2014 [updated 2014 Dec; cited 2015 Feb]. Available from:

  • 11. Grigorov E Vaseva V Getov I. Applied pharmacoeconomics - methodology structuring and conducting of pharmacoeconomical studies Journal of Intern Sci Publ: Economy & Business 2013; 7 ( 1 ):540-551.

  • 12.[Internet]. Helsinki: Swedish Agency for Health Technology Assessment and Assessment of Social Services; 2014 [updated 2015 Jan; cited 2 0 1 5 Dec] . Availablefrom: Page.asp?Cat ID=27&Page ID=132.

  • 13.[Internet]. Helsinki: Swedish Agency for Health Technology Assessment and Assessment of Social Services; 2014 [updated 2014 Aug; cited 2 0 1 5 Jan] . Availablefrom: Page.asp?Cat ID=27&Page ID=273.

  • 14.[Internet]. Sydney: Australian Government; 2014 [updated 2014 Jul 7; cited 2015 Mar]. About the PBS. Available from:

  • 15. Johannesson M. The Australian guidelines forsubsidisationofpharmaceuticals . Pharmacoeconomics. 1992;2(5):355-62.

  • 16.[Internet]. London: National Institute for Clinical Excellence; 2014 [updated 2015 Jan cited 2015 Dec].Aguide to NICE.Available from:

  • 17.[internet]. Frankfurt: Institute for Quality and Efficiency in Health Care. The Institute; 2014 [updated 2015 Feb cited 2015 Sept].Available from:

  • 18.[Internet]. Frankfurt: Bundesministerium fur Gesundheit; 2014 [updated 2014 Aug; cited 2015 Jan]. Newsletter des Bundesministerium fur Gesundheit. Ulla Schmidt in den USA. Health Policy and Health Economics in Germany. Available from:

  • 19.Vekov T Hristov G Dzhambazov S. Health technology assessment. 1st ed. Sofia: Bulgarian Cardiac Institute; 2014.

  • 20. Mears RTaylor R Littlejohns P Dillon A. Review of international health technology assessment. London: National Institute for Clinical Excellence; 2000.

  • 21. Martelli F La Torre G Di Ghionno E Staniscia T Neroni M Cicchetti A. Health technology assessment agencies: an international overview of organizational aspects. Int J Technol Assess Health Care. 2007;23(4):414-24.

  • 22.[Internet]. Paris: Haute Autorite de Sante. Presentation de la HAS. Saint-Denis La Plaine Haute Autorite de Sante; 2008 [updated 2010 Sept; cited 2011Oct].Available from:

  • 23.[Internet]. Paris: Haute Autorite de Sante. Rapport d'activite; 2007 [updated 2006 Dec; cited 2015 Jul 9]. Available from:

  • 24. Garrido MV. Health technology assessment and health policy-making in Europe. Current status challenges and potential. Copenhagen: WHO Regional Office Europe; 2008.

  • 25.VekovТ Dzhambazov S Grigorov E Kolev J. Analytical model for assessment of the pharmaeconomical evidences offered in the process of price formation and reimbursement of medicinal products. Med Man Health Policy. 2014;45(4):3-12.

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