Health technology assessment in Italy

Abstract

Objectives:The aim of this study was to review the history of health technology assessment (HTA) in Italy. Methods: Founded in 1978, the Italian National Health Service (NHS) has been strongly regionalized mainly after a constitutional reform, which started a devolution process. HTA started in the 1980s at the National Institute of Health and in a few University Hospitals, with a focus on big ticket technology: that process was driven by clinical engineers. Results: In recent years, HTA is becoming an important tool for decision-making processes at central, regional, and local levels. In particular, the National Agency for Regional Health Services (AGENAS) and five regions (of twenty-one) are strongly committed to develop HTA initiatives connected with the planning process. Conclusions: At the local level, the hospital-based HTA activity is probably the most important peculiarity of the country and the real driver of the HTA movement.

Avaliação de tecnologias em hospitais de ensino: desafios atuais.

“…Por esta razão, se a decisão deve ser tomada em um nível organizacional, evidências e dados devem ser também coletados e analisados no contexto organizacional (6), (7).…”

“…Políticos, gestores hospitalares, médicos e outros profissionais estão cada vez mais inseridos na responsabilidade em adotar os conceitos de ATS nos seus serviços (6) , (7).…”

Hospital-Based Health Technology Assessment: Developments to Date

“…In Italy, hospital-based HTA activities are reported in several hospitals, and hospital-based HTA is considered the real driver of the country's HTA movement [3]. One example is the HTA unit at the Policlinico A. Gemelli in Rome, a university health centre comprising five healthcare organizations covering acute, rehabilitation and nursing home care [4,18].…”

“…For instance, in Canada, the Canadian Agency for Drugs and Technologies in Health (CADTH) is the entity in charge of HTA at the national level, whereas some Canadian provinces, such as Quebec and Ontario, have their own HTA agencies at the provincial level [2]. In Italy, the National Agency for Regional Healthcare Services (AGENAS) conducts some HTA activities at the national level, and several of the 21 regions of the country also perform HTA activities at the regional level [3].…”

Diffusion and use of health technology assessment in policy making: What lessons for decentralised healthcare systems?

“…Within EU context, limited number of studies analysed the role of HTA in decentralised systems and showed that increasing autonomy assigned to the lower levels of government usually fosters the development of HTA programmes and activities at the regional level leaving the role of national level HTA bodies rather ambiguous [11][12][13][14][15][16]. In all the studies, regional models usually appear to be very different among them in terms of organization, institutional framework, stakeholders and aims.…”