Status, Challenges, and Development
Published online by Cambridge University Press: 01 April 2000
The objectives of this paper are to describe the status anddevelopment of health technology regulation with regard to coveragedecisions and utilization, and to analyze the current situation ofhealth technology assessment (HTA) in Germany. The relevantliterature for controlling health technologies was identified bysearching the literature and databases and through personal contacts. Theliterature was analyzed with regard to the different sectors in thehealthcare system. For the analysis of the current state of HTA in Germany, a national survey was carried out. In addition, the names of topicsunder assessment were collected. The results show that coverage decisions in the ambulatory sector appear to be much more regulated than those in the inpatient sector. The same is true for diffusionand usage of technologies. The strict separation of the hospitaland the ambulatory care sector in Germany constitutes a barrier toregulation and to making HTA an effective instrument inGermany. Until recently, HTA in Germany focused onbiotechnology, such as gene technology. Recently the German ScientificWorking Group of Technology Assessment in Health Care has adopted asystematic methodology to undertake HTAs.It can be concluded that regulation of health technologies inGermany is characterized by inconsistencies ranging from strictregulation in the ambulatory sector to almost no regulation in therehabilitation sector. Increasing interest in HTA, in conjunctionwith a high priority assigned to evaluation of health technologiesby the newly elected government, is likely to improve this situationin the future.