Skip to main content Accessibility help

Patient-based health technology assessment: A vision of the future

  • John F. P. Bridges (a1) and Christopher Jones (a1)


Background: In conjunction with other important movements in contemporary medicine, including evidence-based medicine (EBM), health technology assessment (HTA) has promoted a culture of critical evaluation. Despite this impact, institutional and methodological challenges are associated with HTA. For example, only in recent years has HTA attempted an open dialogue with patients; however, this is normally done by giving them a “seat” at the HTA decision-making table, rather than by more scientific means.

Objectives: The aim of this study was to develop a working definition of patient-based HTA, to identify the current barriers to adopting a patient-based model, and to formulate a vision of how a patient-based HTA could be used to promote patient empowerment and patient-centered care.

Results: In the ideal setting, a patient-based HTA would promote patient knowledge by providing access to information and promoting an informed dialogue between patients and their healthcare professionals. To implement a patient-based HTA, the focus must turn to the patient's issues and incorporate each patient's unique perspective and preferences. Processes must change to increase patient participation in all levels of HTA and aim to promote empowered patients who can make informed decisions.

Conclusions: Present-day HTA is broad and has numerous stakeholders, with none so important as the patient. By asking patient-oriented questions in HTA and better involving patients throughout the entire process, we can easily promote patient empowerment, and as such make patients more capable to play a more active role in healthcare decision making.



Hide All
Banta D, Behney CJ. 1978. Assessing the efficacy and safety of medical technologies. Washington: Office of Technology Assessment;
Bastian H. 2000 Allies or enemies? Evidence-based medicine and consumer choice. Med J Aust. 172: 56.
Bastian H, Kaiser T, Matschewsky S. 2005 Promotion of general health and scientific literacy via consumer and patient information: The role of IQWiG. Z Arztl Fortbild Qualitatssich. 99: 379385.
Battista RN. Towards a paradigm for technology assessment. In: Peckham M, Smith R, eds. 1996. The scientific basis of health services. London: BMJ Publishing Group;
Battista RN, Hodge MJ. 1999 The evolving paradigm of health technology assessment: Reflections for the millennium. Can Med Assoc. 160: 14641467.
Birch S, Gafni A. 2006 The biggest bang for the buck or bigger bucks for the bang: The fallacy of the cost-effectiveness threshold. J Health Serv Res Policy. 11: 4651.
Bridges J. 2006; What can economics add to health technology assessment? Please not another cost-effectiveness analysis! Expert Rev Pharmacoeconomics Outcomes Research. 6: 1924.
Bridges J. 2005 Future challenges for the economic evaluation of healthcare: Patient preferences, risk attitudes and beyond. Pharmacoeconomics. 23: 317321.
Bridges J. 2003 Stated preference methods in health care evaluation: An emerging methodological paradigm in health economics. Appl Health Econ Health Policy. 2: 213224.
Bridges J. 2006 Lean systems approaches to health technology assessment: A patient focused alternative to cost-effectiveness analysis. Pharmacoeconomics. 24 (Suppl 2): 101109.
Donaldson C. 2001 Eliciting patients values by use of ‘willingness to pay’: Letting the theory drive the methods. Health Expect. 4: 180188.
Draborg E, Andersen CK. 2006 Recommendations in health technology assessments worldwide. Int J Technol Assess Health Care. 22: 155160.
Draborg E, Gyrd-Hansen D, Poulsen PB, Horder M. 2005 International comparison of the definition and the practical application of health technology assessment. Int J Technol Assess Health Care 21: 8995.
Florin D, Dixon J. 2004 Public involvement in health care. BMJ. 328: 159161.
Gafni A, Birch S. 2006 Incremental cost-effectiveness ratios (ICERs): The silence of the lambda. Soc Sci Med. 62: 20912100.
Goldenberg MJ. 2006 On evidence and evidence-based medicine: Lessons from the philosophy of science. Soc Sci Med. 62: 26212632.
Henshall C, Oortwijn W, Stevens A, Granados A, Banta D. 1997 Priority setting for health technology assessment: Theoretical considerations and practical approaches. Int J Technol Assess Health Care. 13: 144185.
Herman J. 1997 Advancing the standards of clinical research: The urgent need for new methods and better data. J Eval Clin Pract. 3: 223227.
Hutton J, McGrath C, Frybourg JM, et al. 2006 Framework for describing and classifying decision-making systems using technology assessment to determine the reimbursement of health technologies (fourth hurdle systems). Int J Technol Assess Health Care. 22: 1018.
Jonsson E. 2002 Development of health technology assessment in Europe. Int J Technol Assess Health Care. 18: 171183.
Jonsson E, Banta HD. 1999 Management of health technologies: An international view. BMJ. 319: 1293.
Keen HI, Pile K, Hill CL. 2005 The prevalence of underpowered randomized clinical trials in rheumatology. J Rheumatol. 32: 20832088.
Loukanova S, Molnar R, Bridges J.Empowered patients”: Who are they and why are they different? 2006; Forthcoming.
Royle J, Oliver S. 2004 Consumer involvement in the health technology assessment program. Int J Technol Assess Health Care. 4: 493497.
Ryan M. 1999 Using conjoint analysis to take account of patient preferences and go beyond health outcomes: An application to in vitro fertilization. Soc Sci Med. 48: 535546.
Salkeld G, Solomon MJ. 2003 An economic perspective on evidence-based patient choice in surgery. ANZ J Surg. 73: 427430.
Velasco M, Perleth M, Drummond M, et al. 2002 Best practice in undertaking and reporting health technology assessments. Int J Technol Assess Health Care. 18: 361422.
Vogt F, Schwappach D, Bridges J. 2006 Accounting for tastes: A German perspective on the inclusion of patient preferences in health care. Pharmacoeconomics. 24: 419423.
Wiseman V, Mooney G, Berry G, Tang KC. 2003 Involving the general public in priority setting: Experiences from Australia. Soc Sci Med. 56: 10011012.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed