The Inclusion of Comparative Environmental Impact in Health Technology Assessment: Practical Barriers and Unintended Con
- PDF / 462,178 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 44 Downloads / 201 Views
EDITORIAL
The Inclusion of Comparative Environmental Impact in Health Technology Assessment: Practical Barriers and Unintended Consequences Brita A. K. Pekarsky1
© Springer Nature Switzerland AG 2020
1 Introduction As health sector professionals, scientists and academics, we recognise that the health sector must contribute to greenhouse gas (GHG) emission-reduction targets. Audits of the health sector show that, in addition to the “usual suspects” (power, transport and waste), anaesthetic gases and propellants in metered dose inhalers are contributors to health sector GHG emissions [1, 2]. Furthermore, health services and technologies differ in their GHG profiles, therefore decisions between options can have implications for the health sector’s GHG emissions. Health economic evaluations (HEEs) and health technology assessments (HTAs) are often guided by the principle of inclusion rather than exclusion of consequences of value. It would appear inevitable that in the current climate, health economists are considering whether the net impact on GHG emissions should be included routinely in the assessments and evaluations. GHG accounting is not a recent phenomenon and at least some of the preconditions for ensuring an efficient and effective integration of the impact of GHG emissions into HEE/HTA have been met. Methods of accounting for GHG emissions are internationally validated [3] and, like health economic methods, subject to continual review and responsive to changes in evidence. There are strong similarities between the guidelines for calculating GHG emissions for a jurisdiction and the guidelines used by public health sector funders for HEE and HTA, most notably the reliance on evidence. While the question of the value of projected change in GHG emissions arising from a decision is subject to debate, there are established carbon markets and prices in many jurisdictions.1 And GHG emission impacts * Brita A. K. Pekarsky [email protected] 1
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
are already incorporated in numerous decision processes in the public and private sector, including in the UK where the Treasury publishes guidance on how to calculate the cost effectiveness of climate change policies [8]. On face value at least, it appears that HEE/HTA could incorporate impacts of GHG emissions. This raises a number of important questions. What are the practical barriers to integrating GHG emission impacts into HEE/HTA methods? What would a set of “green” HEE/HTA guidelines look like? Would they be costly to implement? Would existing reimbursement processes become more or less at risk of gaming? And are there more effective ways for the health economists to contribute to GHG emission-reduction targets in the health sector?
2 Practical Barriers to Routine Inclusion of Greenhouse Gas (GHG) Emission Impacts Despite the similarities in these two assessment processes, there are at least three practical barriers to routine integration of GHG emission impacts in HEE/HTA met
Data Loading...
