The role of economic appraisal in health technology assessment: the Australian case.
This paper examines the role and importance of economic appraisal of health technology in Australia, particularly those appraisals conducted under the auspices of a Federal Committee. Eight specific examples are considered: extracorporeal shock wave lithotripsy, office pathology testing, magnetic resonance imaging, cervical cancer screening, bone mineral assessment, automated implantable cardiac defibrillators, liver transplantation and extracorporeal membrane oxygenation. It was found that in most cases the appraisal influenced policy, but that it was harder to assess whether there had been changes in practice or final health outcomes. It is concluded that the roles and relationships of the various players in technology assessment need to be clear, that appropriate incentives are required if socially desirable priorities are to be achieved and that the application of economic appraisal techniques needs to be timely and relevant.
Smith
C S
CS
Monash University, Melbourne, Australia.
Hailey
D
D
Drummond
M
M
D015502:Absorptiometry, Photon / Q000191:economics / Q000592:standards; D001315:Australia; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics / Q000592:standards; D015199:Extracorporeal Membrane Oxygenation / Q000191:economics / Q000592:standards; D005260:Female; D005544:Forecasting; D006291:Health Policy / Q000191:economics*; D006292:Health Priorities; D006801:Humans; D008096:Lithotripsy / Q000191:economics / Q000592:standards; D016031:Liver Transplantation / Q000191:economics / Q000592:standards; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000592:standards; D008403:Mass Screening / Q000191:economics / Q000592:standards; D009042:Motivation; D010338:Pathology, Clinical / Q000191:economics / Q000592:standards; D013673:Technology Assessment, Biomedical / Q000191:economics*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control