Affiliation:
1. University of Cambridge
Abstract
Abstract
Member states have consistently limited the European Union's competences in the area of health care reimbursement. Despite these efforts, there has been a slow but steady tendency toward harmonization of a key tool in reimbursement decision-making: health technology assessment (HTA), a multidisciplinary evaluation of “value for money” of medicines, devices, diagnostics, and interventions, which provides expert advice for reimbursement decisions. This article examines the origins of this paradoxical appetite for harmonization as well as of the dissensus that has, at the moment, somewhat stalled further integration in HTA. It finds that the prointegration neofunctionalist “permissive dissensus” is still present in decision making on HTA but potentially offset by dissensus or outright opposition from key actors, including member states and the medical device industry. These actors are able to decipher the potential consequences of highly technical issues, such as HTA, for national systems of social protection. Despite that, they have little interest in politicizing the issue, potentially opening the door to integrative policy solutions in the future.
Reference90 articles.
1. AESGP, EFPIA, EUCOPE, EuropaBio, Medicines for Europe, and PPTA. 2018. “Joint Pharmaceutical Industry Statement on the Commission's Proposal for a Regulation on Health Technology Assessment (HTA).” June22. www.efpia.eu/news-events/the-efpia-view/statements-press-releases/22062018-joint-pharmaceutical-industry-statement-on-the-commission-s-proposal-for-a-regulation-on-health-technology-assessment-hta/.
2. AIM (Association Internationale de la Mutualité). 2017. “AIM Response to Commission on HTA.” ec.europa.eu/health/technology_assessment/consultations/cooperation_hta_en (accessed September2, 2020).
3. Europe's New Device Regulations Fail to Protect the Public;Allan;BMJ,2018
4. Development of Archetypes for Non-Ranking Classification and Comparison of European National Health Technology Assessment Systems;Allen;Health Policy,2013
5. EU Regulation of Medical Devices and Pharmaceuticals in Comparative Perspective;Altenstetter;Review of Policy Research,2007
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