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Disinvestment Activities and Candidates in the Health Technology Assessment Community: An Online Survey

  • Julie Polisena (a1), Gerhard Trunk (a2), Iñaki Gutierrez-Ibarluzea (a3) and Roberta Joppi (a4)

Abstract

Objectives

As healthcare decision makers continue to face challenges in health services delivery to their patients, disinvestment programs are being established for a sustainable healthcare system. This study aimed to collect data and information by means of a survey of disinvestment candidates and ongoing disinvestment projects in the health technology assessment (HTA) community.

Methods

An online survey was conducted to collect information on disinvestment candidates and activities from members of the Health Technology Assessment International Disinvestment & Early Awareness Interest Group, the EuroScan International Network and International Network of Agencies for Health Technology Assessment.

Results

Among the 362 invitees, twenty-four unique responses were received, and almost 70 percent were involved in disinvestment initiatives. The disinvestment candidates identified represented a range of health technologies. Evidence or signaling of clinical ineffectiveness or inappropriate use typically led to the nomination of disinvestment candidates. Health technology assessments and reassessments were usually conducted to evaluate the technology in question, and decisions usually led to the limited use of the technology. Barriers to disinvestment decisions included the strength of interest and advocacy groups, insufficient data for assessments, a systematic decision process and political challenges, while obstacles to their implementation were clinicians’ reluctance and insufficient funding and incentives.

Conclusions

The survey results suggested that disinvestment activities are occurring in the HTA community, especially in the public sector. Future research can further investigate the processes and methods used to reach and implement disinvestment decisions from our survey respondents and explore to form closer ties between the HTA and clinical communities.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Julie Polisena, E-mail: juliep@cadth.ca

Footnotes

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The authors thank all the respondents to this survey for their time and effort in providing valuable information and the HTAi for supporting this study. As well, the authors thank Eva Reviriego from Osteba for their help on the survey design and dissemination, and Dr. Laura Weeks for reviewing the draft manuscript. This study was funded by the Health Technology Assessment International (HTAi).

Footnotes

References

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Disinvestment Activities and Candidates in the Health Technology Assessment Community: An Online Survey

  • Julie Polisena (a1), Gerhard Trunk (a2), Iñaki Gutierrez-Ibarluzea (a3) and Roberta Joppi (a4)

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