This background paper is part of a larger study on International Differences in Health Care Technology and Spending, which consists of a series of back- ground papers. International Health Statistics: What the numbers mean for the United States was published in November 1993, and International Comparisons of Administrative Costs in Health Care appeared in September 1994. An additional background paper will report on lessons for the United States from a comparison; of hospital financing and spending in seven countries.

Examines the management of health care technology in 8 countries: Australia, Canada, France, Germany, the Netherlands, Sweden, the U.K & the U.S. Six technologies (or sets of technologies) -- including evaluation & management efforts & how the technologies diffused -- are presented & compared: treatments for coronary artery disease, imaging technologies (CT & MRI scanning), laparoscopic surgery, treatments for end-stage renal disease, neonatal intensive care, & breast cancer screening. Extensive bibliography for each country. Charts & tables.

Since 1945, a broad array of health care technologies have come into use, including antibiotics, anti-hypertensive drugs, oral diuretics, oral contraceptives, psycho-pharmaceuticals, corticosteroids, vaccines, open-heart surgery, genetics screening, automated clinical laboratories, renal dialysis, and cardiac pacemakers. Unquestionably, these technologies have brought benefits to millions. However, as costs of health care have risen rapidly, governments have increasingly singled out expensive technology as the culprit. The result has been changes in the methods of paying for health care in most countries to control cost rises. This has led to a slowing of technological change in some countries and increasing necessities to choose in all countries. This timely work describes how technology assessment critically evaluates the benefits, costs, and social implications of technology. The book presents an international perspective on health care technology's development and diffusion, and explains how health care technology can enlighten difficult choices faced by policy-makers, clinicians, and patients.

This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA’s features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.

Market access is the process by which a pharmaceutical company gets its product available on the market after having obtained a marketing authorization from a regulatory agency and by which the product becomes available for all patients for whom it is indicated as per its marketing authorization. It covers a group of activities intended to provide access to the appropriate medicine for the appropriate group of patients at the appropriate price (in most countries). Market Access may also be seen as activities that support the management of potential barriers, such as non-optimal price and reimbursement levels, the restriction of the scope of prescribing for the drug or complicated prescription writing or funding procedures. Since there are cultural differences among countries, any Market Access strategy needs to be culturally sensitive. Pharmaceutical Market Access in emerging markets has been extensively discussed in our previous book, published in 2016. The present book focuses on developed markets with the goal of helping students, academics, industry personnel, government workers, and decision makers understand the environment in developed markets.

This volume contains an Open Access Chapter - This book provides a comprehensive understanding of the sustainability of health systems in Europe. Furthermore, it includes an introduction on how EU action in supporting health- care policies in the EU Member States, both looking at implemented actions and describing current priorities for the future.

This is the second book in the series of books that we edit on the Management of Medical Technology (MMT) published by Kluwer Academic Publishers. The fIrst book Managing Technology in Health Care offered a broad-brushed view of the topics involved in the new and exciting area of MMT that we have launched. A group of distinguished scholars contributed to the fIrst book. While working on the first book in the series, and on a variety of articles in MMT, we began to realize that there is an urgent need for a comprehensive and highly focused book which will introduce and define the area of MMT. In addition, we had just completed the two studies of MMT in American hospitals, and had a magnificent database fully analyzed. With three months left in the first author's sabbatical, and thanks to the encouragement from our editor at Kluwer, Gary Folven, we took to the task of writing this book. The merging in this book of the description of a new intellectual space, and the write-up of the results from our MMT studies have created a unique blend of very attractive reading material. The reader will find this book to be a fascinating adventure into a newly-created area of intellectual endeavor, coupled with fIndings about how the health care delivery system manages teclUlology. Regardless of the reader's background, this book will certainly be of interest, as it links the medical and business frameworks.