Health technology assessment in Europe: Communicating and applying lessons learned from high-income countries to middle-income countries

Abstract Continuous innovation and research in health result in the development of new medical technologies. Such technologies demonstrate varying levels of costs and effectiveness, with some producing benefits at comparable or lower costs while others result in higher levels of health expenditure. European health systems are constrained by limited resources, and health managers and policymakers face choices regarding what new technologies to fund. Such decisions are increasingly supported by health technology assessment (HTA). While formal HTA agencies and networks are predominant in high-income European countries, they rarely exist in middle-income European countries. This is despite the fact that such countries have a greater need for the evidence base and cost-effectiveness of new health technologies to guide funding decisions due to lower levels of resources as well as increasing pressures from pharmaceutical and health-technology companies. High-income European countries should therefore provide technical assistance and support for their middle-income counterparts to institutionalise HTA in health policy-making across Europe.