title: Health technology assessment in India: the potential for improved healthcare decision-making.
abstract: Health technology assessment (HTA) is a multidisciplinary approach that uses clinical effectiveness, cost-effectiveness, policy and ethical perspectives to provide evidence upon which rational decisions on the use of health technologies can be made. It can be used for a single stand-alone technology (e.g. a drug, a device), complex interventions (e.g. a rehabilitation service) and can also be applied to individual patient care and to public health. It is a tool for enabling the assessment and comparison of health technologies using the same metric of cost-effectiveness. This process benefits the patient, the health service, the healthcare payer and the technology producer as only technologies that are considered cost-effective are promoted for widespread use. This leads to greater use of effective technologies and greater health gain. The decision-making process in healthcare in India is complex owing to multiplicity of organizations with overlapping mandates. Often the decision-making is not evidence-based and there is no mechanism of bridging the gap between evidence and policy. Elsewhere, HTA is a frequently used tool in informing policy decisions in both resource-rich and resource-poor countries. Despite national organizations producing large volumes of research and clinical guidelines, India has not yet introduced a formal HTA programme. The incremental growth in healthcare products, services, innovation in affordable medical devices and a move towards universal healthcare, needs to be underpinned with an evidencebase which focuses on effectiveness, safety, affordability and acceptability to maximize the benefits that can be gained with a limited healthcare budget. Establishing HTA as a formal process in India, independent of healthcare providers, funders and technology producers, together with a framework for linking HTA to policy-making, would help ensure that the population gets better access to appropriate healthcare in the future.
authors: South Asia Network for Chronic Disease, Public Health Foundation of India, C-1/52, Safdarjung Development Area, New Delhi 110016, India.
authors: Mrityunjai
authors: M
authors: Kumar
authors: South Asia Network for Chronic Disease, Public Health Foundation of India, C-1/52, Safdarjung Development Area, New Delhi 110016, India.
authors: Shah
authors: S
authors: Ebrahim
authors: Cochrane Heart Group, London School of Hygiene and Tropical Medicine, UK.
authors: Fiona C
authors: FC
authors: Taylor
authors: Indian Institute of Public Health-Delhi, Public Health Foundation of India, India.
authors: Maulik
authors: M
authors: Chokshi
authors: University of Southampton, UK.
authors: John
authors: J
authors: Gabbay
mesh_terms: D020811:Biomedical Technology / Q000592:standards* / Q000639:trends*; D003657:Decision Making; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends; D019317:Evidence-Based Medicine / Q000592:standards / Q000639:trends; D006291:Health Policy / Q000639:trends; D006801:Humans; D007194:India; D010348:Patient Care Team / Q000592:standards* / Q000639:trends*