Some weeks ago I attended the meeting of the Spanish Health Techonology Assessment Association. The presentations and communications highlighted the current status on economic evaluation, and to be honest, an uncertain application and usefulness for public policy in our country. The reason?. There is a fear, a deep fear, that economic evaluation could guide some coverage decisions. Since this represents a reduction of discretionary powers, politicians prefer the status quo. Any change that represents an introduction of health technology assessment will reduce the degrees of freedom in their decisions. Is this fair for society? I would like somebody to calculate the opportunity cost for such a delay.
PS. I suggest you have a look at Sculpher, Peiró and Culyer presentations. My presentation was about stratified medicine, and J. Pons about the state of the art in HTA.
PS. Tomorrow, Conference at Fundació Grifols: Personal and collective determinants of health ailments, Whose responsibility is it?. Determinantes personales y colectivos de los problemas de salud, ¿de quién es la responsabilidad? I'll give a speech in the first session.