Evaluation of health care technologies in the United States compared to Canada and European countries

This paper presents the results of the first comprehensive international su rvey to catalogue health technology assessment (HTA) activities. By 1995, t here were formal HTA programs in 24 countries, established mostly in the la te 1980s and early 1990s. European countries generally have one or two fede ral or provincial HTA programs each. Canada has an extensive network of fed eral and regional organizations coordinated by a central body, and the US h as 53 HTA organizations, the vast majority of which are in the private sect or. While the commitment of the US government to HTA has been erratic, the private sector has been witness to an expansion of HTA activities by insura nce companies, hospitals, medical/device manufacturers, consulting firms, a nd health professional societies. In contrast to other developed countries, the current state of technology assessment in the US is decentralized, fra gmented, and duplicative. We conclude by discussing the importance of a US HTA agency at the national level.