title: Health technology assessment in Poland and Scotland: comparison of process and decisions.
abstract: OBJECTIVE
  We compared Polish and Scottish Health Technology Assessment (HTA) process in order to elicit recommendations for future development of HTA methodological guidelines in Poland.
  
  
  METHODS
  We studied the differences between Polish and Scottish HTA methodological guidelines. HTA recommendations issued by Polish HTA agency (AHTAPol) in the period January 1 through December 31, 2008, were benchmarked to HTA guidance published by Scottish Medical Consortium (SMC) for the same drug technology.
  
  
  RESULTS
  The Scottish HTA methodological guidelines were more instructive in terms of clinical and economic evaluations than Polish guidelines. SMC evaluated forty-eight of sixty-eight drug technologies appraised by AHTAPoL. There were thirty drug technologies that received similar guidance in both countries and eighteen with contradictory HTA recommendations. In Scotland, there were more positive HTA recommendations than there were in Poland. While comments about efficacy or safety were commonplace among reasons for negative recommendations in Poland, insufficient justification of treatment's cost in relation to benefits was the most often cited reason for rejection in Scotland. SMC tended to recommend restricted use to specific sub-populations for several drug technologies negatively appraised by AHTAPoL.
  
  
  CONCLUSIONS
  The comparison between SMC and AHTAPoL suggests that there is potential room of improvement of the Polish HTA methodological guidelines. Comparative effectiveness and safety, subgroup analysis, and adaptation of models to local settings were identified as key areas for further development of Polish HTA methodological guidelines.
authors.affiliation: Warsaw Medical University. kkolasa@wum.edu.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kolasa
authors.forename: Radek
authors.initials: R
authors.lastname: Wasiak
mesh_terms: D003657:Decision Making; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006291:Health Policy; D006801:Humans; D011044:Poland; D012606:Scotland; D013673:Technology Assessment, Biomedical / Q000191:economics* / Q000706:statistics & numerical data