DALLA SPENDING REVIEW ALL’HTA, STRUMENTO INFORMATO PER IL DISINVESTIMENTO: PROPOSTE DELL’HEALTH POLICY FORUM

[Autom. eng. transl.] The identification of the requirements for starting a process of divestment of technologies health care within the Italian NHS based on Hta logic, represents a valid alternative to the spending review and to the more general policies of linear cuts. The start of the divestment process requires a clear and transparent mandate by the economic and health policy authorities, while allowing to differentiate the divestment decisions taken with a view to efficiency (for eliminate waste) from those reallocation decisions more specifically times to maximize the opportunity cost and thus to sacrifice fewer performance levels priority in favor of the more priority ones. A desirable approach for divestment, aimed at estimating their value internally of patient paths and specific organizational contexts, involves the definition of the phases of: • identification of health technologies, which can be achieved through definition of measurable and transparent priority criteria; • (re) assessment of existing technologies carried out from a HTA perspective through a process explicit, participatory and evaluable, as well as coordinated between the levels of the NHS; • decision making in which the problem of managing uncertainties and uncertainties arises pressure exerted by interest groups. The role of each stakeholder in every single phase of the divestment process has been defined, which can only be guaranteed if you define the rules of engagement and yes guarantees a dissemination of the culture of divestment.