title: A regulatory governance perspective on health technology assessment (HTA) in France: the contextual mediation of common functional pressures.
abstract: The new regulatory governance perspective has introduced several insights to the study of health technology assessment (HTA): it has broadened the scope for the analysis of HTA; it has provided a more sophisticated account of national diversity and the potential for cross-border policy learning; and, it has dissolved the distinction between HTA assessment and appraisal processes. In this paper, we undertake a qualitative study of the French process for HTA with a view to introducing a fourth insight: that the emergence and continuing function of national agencies for HTA follows a broadly evolutionary pattern in which contextual factors play an important mediating role. We demonstrate that the French process for HTA is characterised by distinctive institutions, processes and evidential requirements. Consistent with the mediating role of this divergent policy context, we argue that even initiatives for the harmonisation of national approaches to HTA are likely to meet with divergent national policy responses.
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Barron
authors.affiliation: Institute of Ethics, History and Theory of Medicine, Ludwig Maximilian's University of Munich, Lessingstr. 2, 80336 Munich, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Klinger
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
authors.forename: Sara Mehmood Birchall
authors.initials: SM
authors.lastname: Shah
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom. Electronic address: j.s.wright@lse.ac.uk.
authors.forename: John S F
authors.initials: JS
authors.lastname: Wright
mesh_terms: D020811:Biomedical Technology / Q000191:economics / Q000331:legislation & jurisprudence; D003362:Cost-Benefit Analysis; D005602:France; D006077:Government Agencies / Q000331:legislation & jurisprudence / Q000458:organization & administration; D033161:Government Regulation; D017048:Health Care Costs; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D011050:Policy Making; D013673:Technology Assessment, Biomedical / Q000331:legislation & jurisprudence*
keywords: European Union; France; Health technology assessment; Healthcare regulation