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Follow us through 8 steps: from EBM to multilevel HTA

8. Future

7. Integration

6. Adaptability

Od EBM do EBHC – fundamenty racjonalizacji decyzji

We embraced EBM—the foundation for organizing medical decisions. Soon, an expanded concept emerged: EBHC—the foundation for building a rational system. Now all we had to do was convince everyone... The Krakow EBHC Symposium became the foundation for dialogue.

The first step towards modern, multidimensional health technology assessment (HTA) was the popularization of the concept of Evidence-Based Medicine (EBM).

At the turn of the 21st century, with the rapid increase in the number of published clinical trials, it became clear that therapeutic decision-making required not only access to individual studies but also their critical appraisal, synthesis, and the use of systematic reviews and meta-analyses. It was in this spirit that we initiated the Evidence-Based Health Care (EBHC) Symposium in Krakow in 2006, which from the outset integrated the scientific, clinical, and policymaking communities around the idea of rationalizing the healthcare system.

Over time, however, it has become clear that clinical effectiveness alone is not sufficient for making optimal healthcare decisions. In Poland, testing of Evidence-Based Health Care solutions began in 2009, and systemic interventions (healthcare interventions) began as pilot programs in 2017.

It was EBHC that laid the foundation for the development of modern health technology assessment (HTA), which is now one of the key tools supporting decision-making in healthcare systems, including healthcare interventions.

Analyses

created in closed scientific environments

Must
demonstrate

real-world utility

And lead

to better health decisions

Our speakers are committed to change

Our references to change

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The birth of HTA – when evidence meets health economics

The expansion of the perspective from EBM to EBHC has incorporated economics into the decision-making process. Cost-effectiveness thinking is now the norm at all levels of healthcare decision-making. Seventy years later, there are now over 100 HTA organizations worldwide!

The next stage of development was the emergence of Health Technology Assessment (HTA) – a systematic evaluation of medical technologies, taking into account their effectiveness, safety, and cost-effectiveness, and increasingly also an analysis of their budgetary impact. However, the concept of HTA itself did not emerge overnight – it originated in the 1970s and gradually expanded its scope over the following decades, from a simple safety assessment to today's multidimensional analysis.

Today, there are at least 54 HTA agencies associated with INAHTA operating worldwide (although, counting all national and regional bodies, some sources even mention over 100 organizations) – and new ones are still being added.

Did you know that the first annual HTAi (Health Technology Assessment International) meeting took place in Krakow in 2004? It was co-organized by the CEESTAHC Association. Since 2006, CEESTAHC has also organized the EBHC Symposium – which will be held for the 21st time in 2026 – continuing to address the role of HTA in decision-making processes at all levels of healthcare.

Research results alone

are not enough to reach our goal

We have begun to chart a course

to better health decisions

Cost and effectiveness

have become the fundamental parameters

We have reached the point

where science meets economics

Our speakers are committed to change

Our references to change

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HTA implementation – from theory to systematic decisions

The implementation of HTA as an analytical tool has enabled its practical use in decision-making processes. HTA has been implemented in the healthcare system through guidelines and standards for clinical practice, as well as reimbursement processes for drugs and non-drug technologies. The transparency of decisions has also increased.

In the following years (1990–2013), HTA transitioned from an academic concept to a tool increasingly used by public institutions and, in some countries, by hospitals and academic centers. The emergence of HTA agencies/units and the development of formal reimbursement processes transformed decision-making.

For 20 years, the EBHC Symposium has provided a platform for exchanging experiences between regulators, scientists, and industry. Topics covered include decision transparency, reporting standards, and assessment methodologies.

HTA is no longer just an analysis; it is a permanent element supporting health policy processes. This is the stage at which we began to discuss process standardization, the role and perspective of stakeholders, and the need to seek consistency in decisions.

The foundations

for new decision-making systems are being laid

Decision-making processes

are needed at many levels,
so expansion is ongoing

The evolution of systems

is never final

Our speakers are committed to change

Our references to change

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HTA without borders – towards international cooperation

After streamlining processes at the national level, the next step was to expand cooperation to the international level. The concept of "shared evidence – local decision" was developed, enabling cooperation in global data exchange while maintaining local decision-making autonomy.

For over 20 years, HTA development has taken on a fully international dimension. Cooperation between EU countries and joint initiatives (e.g., the Joint Clinical Assessment) are enabling drug assessments at a supranational level for the first time. But will this lead to increased system efficiency?

The EBHC Symposium consistently expanded its thematic scope to include the harmonization of methods and common standards for health technology assessment. The concept of "shared evidence, local decision" was introduced. This meant that clinical data could be shared while financial decisions remained local. It was here that the first foundations for multi-level thinking about HTA emerged – international, national, local, and facility-level.

The broader the perspective

of data collection

The greater the awareness

of the benefits of international exchange

Our speakers are committed to change

Our references to change

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Patient at the center – broadening the perspective of HTA

International collaboration and the growing maturity of the system have led to a redefinition of the value of therapy in terms of patient needs. This has led to the incorporation of the patient perspective, including PRO and quality of life, as a key element of health technology assessment.

Taking the patient perspective into account prepared the system for a more comprehensive approach, which was put to the test during the COVID-19 pandemic. As a result, HTA has evolved towards greater flexibility, speed, and the ability to function in conditions of uncertainty.

Between 2016 and 2019, HTA began to incorporate the patient perspective. The question was increasingly asked: what role does technology play in quality of life? The EBHC Symposium addressed the topics of Patient-Reported Outcomes (PRO), patient experiences, and clinical value perceived by system users. HTA began to evolve from an economic model to a health value model. Increasing patient participation paved the way for more complex decision-making models.

Patients' voice

is heard thanks to improved
communication within the system

Listening
to patients' voices

brings results

What allows us
to build new structures

oriented towards better
meeting the needs

Our speakers are committed to change

Our references to change

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