['Medical technology assessment'; more than just efficacy]

Abstract

'Medical technology assessment' means investigating the developments, costs and effects of medical technologies. Practising physicians increasingly are confronted with consequences of management based on such research results. In order to follow and participate in the discussion they should be aware of this and know the jargon. In policy problems, measures of effect in natural units (e.g. cardiovascular mortality) offer advantages over measures of clinical findings (e.g. decrease of the serum cholesterol levels). Survival in various health states and disorders can be compared by multiplying the number of life years gained by a factor for the quality of life in those years. Costs are usually expressed in monetary terms. These may be calculated as direct medical costs on the basis of fees or actual costs for society. The latter is the case when the balancing is based on a societal perspective. The societal perspective enables a more objective assessment of health effects than when a patient perspective is used. 'Incremental cost effectiveness' expresses where extra expenditures will have maximum effect, and bears higher relevance for policy decisions than mean costs per unit of effect. Immaterial matters are more difficult to assess, but should nevertheless be considered in selecting the policy to be implemented.