Assessment and regulation of health care technology - The Dutch experience

Objectives: To evaluate the characteristics, methods, and results of the Du tch Investigative Medicine Program ("ontwikkelingsgeneeskunde") in policy a nd health care. Methods: Project database analyses of the initial 9 years of the program; d escription of characteristics, methods, and effects of the program. Results: By the end of 1997, 53 projects had been completed, including impl ementation in health care policy. In 20 at 53 cases the program worked as a n instrument to prevent the introduction of ineffective, inefficient, or ev en harmful medical interventions. In most other cases the program assisted with proper placement or appropriate application of new technologies,Apart from new or emerging technologies, already existing technologies are evalua ted. Conclusion: The Dutch Investigative Medicine Program ("ontwikkelingsgeneesk unde") of the Sickness Funds Council is an effective collaboration of healt h care providers, medical science, health economics, and a regulatory body in empirical technology assessment. It is also-an example not only of a sub stantial contribution of technology assessment to decision making in practi ce and policy but also of a means of regulation of health care by the very activity of technology assessment itself. It appears that the program has e volved into an instrument to rationalize health care and health care policy , although some further possible improvements are identified.