title: Similarities and differences between stakeholders' opinions on using Health Technology Assessment (HTA) information across five European countries: results from the EQUIPT survey.
abstract: BACKGROUND
  The European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) project aimed to study transferability of economic evidence by co-creating the Tobacco Return On Investment (ROI) tool, previously developed in the United Kingdom, for four sample countries (Germany, Hungary, Spain and the Netherlands). The EQUIPT tool provides policymakers and stakeholders with customized information about the economic and wider returns on the investment in evidence-based tobacco control, including smoking cessation interventions. A Stakeholder Interview Survey was developed to engage with the stakeholders in early phases of the development and country adaptation of the ROI tool. The survey assessed stakeholders' information needs, awareness about underlying principles used in economic analyses, opinion about the importance, effectiveness and cost-effectiveness of tobacco control interventions, and willingness to use a Health Technology Assessment (HTA) tool such as the ROI tool.
  
  
  METHODS
  A cross sectional study using a mixed method approach was conducted among participating stakeholders in the sample countries and the United Kingdom. The individual questionnaire contained open-ended questions as well as single choice and 7- or 3-point Likert-scale questions. The results corresponding to the priority and needs assessment and to the awareness of stakeholders about underlying principles used in economic analysis are analysed by country and stakeholder categories.
  
  
  RESULTS
  Stakeholders considered it important that the decisions on the investments in tobacco control interventions should be supported by scientific evidence, including prevalence of smoking, cost of smoking, quality of life, mortality due to smoking, and effectiveness, cost-effectiveness and budget impact of smoking cessation interventions. The proposed ROI tool was required to provide this granularity of information. The majority of the stakeholders were aware of the general principles of economic analyses used in decision making contexts but they did not appear to have in-depth knowledge about specific technical details. Generally, stakeholders' answers showed larger variability by country than by stakeholder category.
  
  
  CONCLUSIONS
  Stakeholders across different European countries viewed the use of HTA evidence to be an important factor in their decision-making process. Further, they considered themselves to be capable of interpreting the results from a ROI tool and were highly motivated to use it.
authors.affiliation: Department of Health Policy & Health Economics, Faculty of Social Sciences, Eötvös Loránd University, 1117, Budapest, Pázmány Péter sétány 1/a, Hungary. zoltan.voko@syreon.eu.|Syreon Research Institute, 1142, Budapest, Mexikói út 65/A, Hungary. zoltan.voko@syreon.eu.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Vokó
authors.affiliation: Caphri School of Public Health and Primary Care, Health Services Research, Maastricht University, Duboisdomein 30, 6229, GT, Maastricht, The Netherlands.
authors.forename: Kei Long
authors.initials: KL
authors.lastname: Cheung
authors.affiliation: Syreon Research Institute, 1142, Budapest, Mexikói út 65/A, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Józwiak-Hagymásy
authors.affiliation: Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Wolfenstetter
authors.affiliation: Health Economics Research Group, Brunel University London, Uxbridge, UB8 3PH, United Kingdom.
authors.forename: Teresa
authors.initials: T
authors.lastname: Jones
authors.affiliation: Centre for Research in Health and Economics, Pompeu Fabra University, Ramon Trias Fargas 25-27, 08005, Barcelona, Spain.
authors.forename: Celia
authors.initials: C
authors.lastname: Muñoz
authors.affiliation: Caphri School of Public Health and Primary Care, Health Services Research, Maastricht University, Duboisdomein 30, 6229, GT, Maastricht, The Netherlands.
authors.forename: Silvia M A A
authors.initials: SM
authors.lastname: Evers
authors.affiliation: Caphri School of Public Health and Primary Care, Health Services Research, Maastricht University, Duboisdomein 30, 6229, GT, Maastricht, The Netherlands.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: Caphri School of Public Health and Primary Care, Health Promotion, Maastricht University, POB 616, 6200, MD, Maastricht, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.affiliation: Health Economics Research Group, Brunel University London, Uxbridge, UB8 3PH, United Kingdom.
authors.forename: Subhash
authors.initials: S
authors.lastname: Pokhrel
mesh_terms: D000288:Administrative Personnel; D001290:Attitude; D001364:Awareness; D003362:Cost-Benefit Analysis; D003657:Decision Making; D055317:Evidence-Based Practice; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D006814:Hungary; D007449:Investments; D009042:Motivation; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011639:Public Opinion; D012907:Smoking / Q000191:economics; D016540:Smoking Cessation / Q000191:economics; D000074606:Smoking Prevention; D013030:Spain; D011795:Surveys and Questionnaires; D013673:Technology Assessment, Biomedical / Q000379:methods*; D006113:United Kingdom
keywords: EQUIPT; Return on investment; Smoking cessation; Stakeholder engagement; Transferability of economic evidence