Introduction<\/p>\n\n\n\n
For over 40 years, Canada has had a publicly funded, national health-care system designed to ensure residents receive \u201creasonable access\u201d to \u201cmedically necessary\u201d health-care services, regardless of their ability to pay [1]. However, unlike many of its European counterparts, Canada\u2019s system is a decentralized one, comprised of 13 separate provincial and territorial health insurance plans. Guided by common values (e.g., equity and solidarity) and responsible for meeting basic standards of coverage, these plans determine how best to organize, manage, and deliver health care within their jurisdictions. Decisions regarding which new technologies to include in the basket of publicly funded services, therefore, rest with individual provinces and territories, and the role of the federal government remains primarily limited to premarket approval and, in the case of patented pharmaceuticals, price regulation. It has, however, retained responsibility for providing services to limited populations, such as veterans, the military, first nations, and inmates. Canada\u2019s history in health technology assessment (HTA), a field developed to support purchasing or coverage decisions, reflects the decentralized nature of the country\u2019s health-care system. Its roots predominantly exist at the provincial level, with the establishment of the Conseil d\u2019evaluation des technologies de la sante (CETS) (now called the Agence des technologies et des modes intervention en sante [AETMIS]) in Quebec 20 years ago [2]. At around the same time, a joint committee representing the federal, provincial, and territorial ministries of health identified HTA as one of its key priorities and announced the creation of a national, independent HTA body called the Canadian Coordinating Office of Health Technology Assessment (renamed the Canadian Agency for Drugs and Technologies in Health (CADTH) in 2006). Funded by the provincial, territorial, and federal governments, its mandate is to provide impartial, evidence-based information on the clinical and economic implications of drugs and other health technologies (including devices, procedures, and systems) to the 13 public insurance plans. Since then, HTA has played an increasingly important role in technology coverage policy in Canada.With the demand for assessments exceeding resources available to the national HTA agency and the types of requests broadening to include context specific questions framed from perspectives other than that of society, the past 20 years have seen the emergence of local HTA initiatives in hospitals, regional health authorities, and provinces across the country. Now more than ever, decision-makers at all levels of government are investing in \u201cinstitutionalized\u201d HTA, creating a landscape shaped by a combination of ongoing national and local efforts. In this article, the production and use of HTA in health-care decisions in Canada is described in Section I. Current issues in technology assessment are discussed in Section II. Section III represents our personal views on lessons learned from the HTA experience in Canada.<\/p>\n","protected":false},"featured_media":0,"template":"","categories":[21],"tags":[],"class_list":["post-225153","hta_library","type-hta_library","status-publish","hentry","category-review-papers"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/hta_library\/225153","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/hta_library"}],"about":[{"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/types\/hta_library"}],"wp:attachment":[{"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/media?parent=225153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/categories?post=225153"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.inbit.gr\/el\/wp-json\/wp\/v2\/tags?post=225153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}