THE ROLE OF ECONOMIC APPRAISAL IN HEALTH TECHNOLOGY-ASSESSMENT - THE AUSTRALIAN CASE

This paper examines the role and importance of economic appraisal of health technology in Australia, particularly those appraisals conducted under the auspices of a Federal Committee. Eight specific examples are considered: extracorporeal shock wave lithotripsy, office pathology testing, magnetic resonance imaging, cervical cancer screening, bone mineral assessment, automated implantable cardiac defibrillators, fiver transplantation and extracorporeal membrane oxygenation. It was found that in most cases the appraisal influenced policy, but that it was harder to assess whether there had been changes in practice or final health outcomes. It is concluded that the roles and relationships of the various players in technology assessment need to be clear, that appropriate incentives are required if socially desirable priorities are to be achieved and that the application of economic appraisal techniques needs to be timely and relevant.