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FIRST CONSIDERATIONS In response to the interest expressed in re-establishing a forum for medical technology assessment, the Institute on June 16, 1982, convened representatives from professional societies, industry, academia, govern- ment, and third-party payers for health care. They were to initiate consideration of such questions as what assessment functions were needed, what organizational structure might best meet the need, what auspices might best suit the structure, and what might be the source of funds for such an organization. Participants variously suggested that functions of a new organization might include (1) the setting of priorities for the conduct of medical technology assessments, (2) supporting and/or conducting such assessments, (3) widely disseminating the results of assessments, (4) supporting research and development of assessment methods, (5) acting as a catalyst for the discussion of assessment issues, and (6) providing a clearing- house for information about assessment. There was ready consensus about the need for timely information that could be used by a variety of organizations and individuals in making decisions appropriate to their own concerns. The meeting made it clear that much further effort would be necessary to develop widely acceptable definitions of technology assessment, to outline the scope of activity of any new entity hoping to coordinate asessment, and to develop a plan of action for establishing and funding such an entity. Success in attracting funding was seen as heavily dependent on the creation of a specific proposal that would cover the six tasks listed above. Important functions not now being adequately performed in various technology assessment efforts were identified by the meeting partici- pants. Included were the lack of a central clearinghouse, the lack of an entity with prime responsibility for coordination and synthesis of assessment information for wide dissemination and education, and the lack of any significant entity responsible for supporting research in assessment. Conferees discussed several advantages of basing a new entity in the private sector and supporting it with both private and public funds. First, a private base could attract broader support from health care professionals and the industry as a whole by being outside of government and its regulatory activities. Second, an essentially private-sector organization would be less subject to political pressures than would a government agency, and therefore could conduct its activities in a more neutral and stable context. Last, a private entity could be seen as more accessible and responsive to its supporters, and could be hoped to 7
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perform with more alacrity and effectiveness. Possible disadvantages to an entity based in the private sector, conferees conceded, could include considerable difficulty in securing adequate long-tenm support for the establishment of effective programs, and an inference of bias in favor of the marketing and profit incentives of private enterprise. Participants requested the Institute to take the lead in developing a plan for the establishment of a private/public sector activity in medical technology assessment. 8