The Newest Three-Letter Fad in Health: Can HTA Escape the Fate of NHA, CEA, GBD?

Abstract

What Can We Learn from the National Health Account Story? Other Misused Three-Letter Tools A Way Forward for HTA References Prioritization in health has always fascinated me, so when I saw that the 2016 Prince Mahidol Awards Conference (PMAC) had “Priority Setting” as the theme for the event (http://pmaconference.mahidol.ac.th/), I was really excited. An early draft of the agenda, however, tempered some of the excitement and raised in my mind an issue that the health sector continues to struggle with when it comes to approaches to prioritization: falling in love with technocratic approaches. Global conversations about prioritization always risk being dominated by a highly technocratic agenda that caters more to a donor-focused environment than national needs for lowand middle-income countries. The most recent of these technocratic approaches, on display at PMAC, is health technology assessments (HTAs). Though there is no doubt that HTAs can and should play an important role in prioritization of limited resources for health, there is a long history of overselling technical answers and in some cases causing more harm than good. The January 2016 issue of Health Systems and Reform, “Special Issue: PrinceMahidol AwardConference 2016: Priority Setting for Universal Health Coverage,” offers some hope. The issue included several commentaries and articles that urge a balanced approach to prioritization, and others explore the limitations of empirical tools like cost effectiveness and HTA. The main question for me is the following: Will the zeal for a technical answer win over the more pragmatic commentary presented in these articles ofHealth Systems&Reform?