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t international levels, there has been a renewed attention to strengthening

health systems in the first decades of the 21st century; a process that has

A received considerable reinforcement as essential component of achieving

the Sustainable Development Goals for health. The pressures to increase the spending in
healthcare sector, need to be accompanied by measures to ensure rational spending and

‘Best-buys’ ensuring a high performance health system. Health systems performance, both in

quality and efficiency must be seen as one crucial challenge that requires rationally adoption
of new health technologies. Most countries with high performance health systems have

health systems that are largely public funded. As public funding increases, so does the need

for greater accountability for spending from public revenues. In such contexts, the process of

rational decision making is even more important.

Health technology assessment (HTA) is being used for making evidence-based
healthcare decisions over the last three decades by many countries in the developed region

(e.g. Europe, US, Canada etc.) and is now also being adopted by many nations in the

developing world which have made good progress towards UHC (especially Thailand, South
Korea, Taiwan etc.). Many nations adopting programmes towards achieving UHC have also

formally started adopting HTA as part of their decision making process in last few years.

Historical Development of HTA, National and International HTA agencies

The term Technology Assessment first came into use in 1965 in the U.S. House of
Representatives during scientific deliberations on establishing a healthcare program. The first

formal HTA committee was structured in 1984, in Catalonia, Spain; which later served as the

foundation of Catalan Agency for Health Technology Assessment (CAHTA). In 1987, Sweden

constituted the Swedish Council for Technology Assessment in Health Care (SBU) for

institutionalizing HTA in the country. Across Canadian region, different provinces started
establishing their HTA institutions like Council for Health Technology Assessment of Quebec

was created in 1988; Ontario Health Technology Advisory Committee in 2003 etc. In 1991,

WHO held a meeting of HTA experts in Geneva raising relevance of HTA and Economic
Evaluation at global level. In 1985, International Society for Health Technology Assessment

(ISTAHC) was constituted. In 1995, Germany started doing HTA and formally established

German Scientific Working Group Technology Assessment for Health Care (GSWG-TAHC) in

1997. United Kingdom established National Coordinating Centre for Health Technology

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