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Setting Priorities for Health Technology Assessment: A Model Process
The committee formulated several general principles to direct its development of a priority-setting process. The first such principle is that a priority-setting process should be consistent with the mission of the organization that uses it. For a public agency, the values of the public that the agency serves need to be incorporated into the process. For OHTA, such a process would require the assembling of information about the potential to improve health outcomes, to reduce inappropriate expenditures, to redress inequity among those receiving health care, and to inform special social issues.
Second, the priority-setting process must consider the information needs of users. The process designed for OHTA should, in general, focus on technology assessment for specific clinical conditions and for alternative approaches to those clinical conditions.
Third, the priority-setting process must be efficient so that scarce resources for technology assessment are not needlessly consumed in the process of setting assessment priorities. OHTA should seek broad input at the outset but also have some relatively simple mechanism to reduce a large set of candidate topics to a smaller one. The process should also take advantage of available data, or, where data are lacking, of subjective judgments, rather than require the collection of new data.
Finally, the priority-setting process must be capable of motivating decision makers in a politically complex environment; it must be—and must appear to be—objective, open, and fair; it must also invite input from a variety of interested parties and present the logic of the process clearly and carefully to others. The chapter that follows presents a process that the committee hopes can be understood as logically deriving from consideration of these issues.