State assessment of medical technologies as a public policy tool: intersectoral interaction in the macroeconomic environment

Abstract

The article examines Health Technology Assessment (HTA) as a contemporary instrument for the formulation and implementation of public policy in the healthcare sector. It is substantiated that, in the context of increasing demand for financing innovative medical technologies, the traditional approach to their assessment, primarily based on the analysis of clinical effectiveness, safety, and budget impact within the healthcare system, no longer ensures a comprehensive consideration of the broader societal consequences of managerial decisions. This issue becomes particularly relevant in the context of Ukraine’s post-war recovery, where public health serves as one of the key determinants of human capital reproduction and long-term socio-economic development.

The study analyzes international approaches to health technology assessment, particularly the concepts of the payer perspective and the societal perspective. It is established that contemporary international practices increasingly focus on accounting for the broader economic and social effects of medical innovations, including their impact on labor productivity, employment, social protection systems, and human capital development. Particular attention is paid to the concept of Social Impact, which enables the assessment of the contribution of medical innovations to the creation of economic value for both the state and society.

The experience of Sweden, the United States, France, and Poland regarding the application of an intersectoral approach to HTA processes is examined. The findings indicate that the most effective HTA models operate through the interaction of healthcare authorities with financial, economic, and social institutions. Special emphasis is placed on the use of Multi-Criteria Decision Analysis (MCDA), which facilitates the integration of medical, economic, social, and strategic criteria into managerial decision-making processes. The study also substantiates the importance of institutionalizing patient involvement in HTA procedures as a prerequisite for improving the transparency, legitimacy, and effectiveness of public policy in healthcare.

Based on the research findings, a conceptual model of intersectoral governance of health technology assessment processes in Ukraine is proposed. The model envisages the establishment of a coordination mechanism involving public authorities, the expert community, and patient organizations. The proposed approach is aimed at overcoming the problem of silo budgeting, ensuring comprehensive consideration of the societal effects of medical innovations, and increasing the efficiency of public resource allocation. The implementation of the proposed model will contribute to the development of a strategically oriented decision-making system in healthcare and strengthen human capital as a key resource for Ukraine’s post-war recovery and sustainable development.