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4 Can health technology assessment lessen the effect of commercial drivers of over diagnosis and over treatment?
  1. Olivia Hibbitt,
  2. Liz Hay,
  3. Vanessa Clements
  1. NSW Ministry of Health, Sydney, Australia


Innovation in healthcare is an important aspect of ensuring our health services continue to provide world class care. Innovation not only affords patients access to new or improved therapies, it is an important source of revenue and is a significant driver of economic growth. However, new health technologies have been recognised as one of the biggest drivers of medical excess. Over-investment without safeguards can leave patients exposed to over diagnosis, over treatment and the medicalisation of normal human conditions. The commodification of the health system drives investment in health technology by creating significant pressures to adopt the latest advancement in medical science. This is often driven by patients, industry, the media and the belief that the new advancement must be better than the existing test or treatment.

Health systems are faced with a complex issue of encouraging the benefits innovation in healthcare can achieve while protecting patients from the harms that may be associated with them. It is tempting to call for more assessment and more regulation around new health technologies. While health technology assessment can be used to drive strategic investment in new technologies, it needs to be implemented effectively to counteract the significant influence of industry and societal pressure to invest. New South Wales has a defined process to the assessment, implementation and monitoring of health technologies. The NSW Health technologies and Specialised Services framework provides advice and tools for local implementation and assessment of new technologies. The framework also outlines the statewide approach to the investment in new health technologies. The framework is designed to maximize patient safety while encouraging investment in innovation. It provides a robust mechanism to assess whether a new technology improves patient outcomes, enhances the experience of giving and receiving care and/or increases efficiency in the health system. Underpinning the new technology framework is a statewide healthcare reform program to move the NSW Health system to a value-based model. This model means delivering services that improve the:

  • Outcomes that matter to patients

  • Experience of receiving care

  • Experience of giving care

  • Effectiveness and efficiency of care.

This session will introduce a case study of industry-driven health technology implementation in NSW. This will be used to discuss how a robust approach to the assessment, implementation and monitoring of new health technologies may ensure timely access to advanced therapies while helping protect patients, clinicians and the health system from investment in technologies that may drive over diagnosis and over treatment. NSW Health will lead discussion on how health systems may optimize the use technology assessment to lessen the effect of commercial drivers of over diagnosis and over treatment.

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