An HTA systems decision-support toolbox for short and long-term healthcare and economic perspectives in an Italian hospital

Objectives: The introduction of a new healthcare technology within the technological facilities of a hospital is a complex action that must go through the mandatory decision-making process of health technology assessment (HTA). Nowadays, developing a universal HTA model poses a significant challenge within the current landscape. This paper describes the proposal of a novel supporting healthcare technology evaluation toolbox, aligned with the principles of the European Network for Health Technology Assessment (EUnetHTA) shared by the Regulation (EU) 2021/2282 on Health Technology Assessment (HTAR). Methods: The proposed toolbox relies on a MATLAB-based multicriteria algorithm that mirrors the evaluative procedure following the hierarchical framework of the analytic hierarchy process. The evaluation framework involves clinical and non-clinical aspects leading to the choice of the best alternative, among the evaluated technologies, to be introduced in the technological infrastructure of the hospital. Moreover, the toolbox incorporates robust economic analysis capabilities, crucial for determining the requisite number of annual hospital procedures to ensure economic equilibrium and mitigate financial risks. Additionally, it computes the payback period, essential for evaluating the economic feasibility of technology investments. HTA evaluations at San Giovanni Addolorata Hospital demonstrate its application. Results: The toolbox exemplifies its efficacy in supporting informed decision-making processes, regarding the adoption of technologies like robotic systems for neurosurgery and angiographic systems, in terms of economic sustainability and clinical effectiveness. Conclusions: This study underscores the toolbox’s role in advancing HTA methodologies and enhancing the efficiency and sustainability of healthcare technology integration.