抄録
It is necessary to evaluate health technology from a multi-disciplinary point of view in relation to policy decisions in publicly-financed health care systems. Originally, health technology had been evaluated from clinical perspectives. As the various outcome measurements such as QOL were invented, the needs of economic evaluations were counted and equity in the allocation of healthcare resources were considered, social value judgements as well as scientific judgements have become very important. HTA encompasses several processes: analysis of the values of the health technology, an appraisal of analysis and policy judgements. In this article, social value judgements are discussed in detail in relation to each process of HTA. Adoption of one particular methodology sometimes brings with it implicit value judgements. This includes adoption of effectiveness measurements and the scope of cost considered. In the appraisal process, equity considerations are always issues. However, equity considerations are on a case-by-case basis, rather than based on objective evidence from social science. HTA is a newborn area in Japan. We need to establish methodologies considering implicit value judgments. Also, analysis of public preference and public discussions are necessary to capture social values.
