The increasing role of health technology assessment in behavior change interventions: what have we learned?

Abstract

Aims: Increase awareness of the need for conducting economic evaluations alongside behavior change intervention studies; alert to methodological challenges when conducting an economic evaluation; draw attention to ways to improve the quality and uniformity of the economic methodology to increase their value and uptake in the health promotion field. Rationale: This symposium reviews the role of health technology assessment and economic evaluations in the health promotion sector. Evidence of cost-effectiveness is indispensable when making decisions about the reimbursement of behavior change interventions. Although economic evaluations are becoming more common in behavior change intervention studies, their applicability and uptake are still scarce. Studies including economic evaluations are not only considered to be more difficult to conduct but also more difficult to peer-review because the economic methodology for preventive interventions is less well defined. Methodological challenges relate, amongst others, to acceptable willingness-to-pay thresholds, limitations of the QALY paradigm, appropriate selection of the comparator, capturing all important costs and benefits, and extrapolation beyond the observation period. Summary: Several types of economic evaluations that have been conducted alongside behavior change intervention studies will be presented to provide an overview of the current state of art of economic evaluation studies in health promotion and public health, their challenges and directions for future. The final discussion will focus on the need to integrate health technology assessment in the health promotion sector, and factors that determine the potential uptake of economic evaluations by stakeholders in the field of health promotion and public health. Ways to improve the quality and uniformity of the economic methodology will be discussed that may increase their value and uptake.