Premise
Cittadinanzattiva, through the Civic Evaluation Agency promotes the culture of the evaluation of public services and policies from a civic point of view in various areas (health, school, justice, local services) at local and national level.

In the context of public health policies, innovation represents a challenge for the whole community and for the well-being and improvement of the quality of life of citizens and patients. The overall sustainability of health care and the responsibility to ensure effective, efficient, fair and respectful services to citizens requires that assessments of new health technologies are the result of a participatory process. For these reasons, Cittadinanzattiva - as a movement for civic participation and protection of citizens' rights in Italy and in Europe - considers the involvement of citizens in the Health Technology Assessment (HTA) to be decisive.

The involvement of citizens and patients and the effective inclusion of their point of view in HTA processes - considered in the literature of the sector as an integral part of the processes for evaluating new health technologies - is not so obvious or guaranteed (see the results of Cittadinanzattiva's recent survey of HTA in some healthcare companies in Italy in “HTA applied to choices in healthcare companies. Results of some interviews”). 

In Italy, Cittadinanzattiva has started dealing with HTA for about 10 years now through the following activities:

1. Insights, sector studies, analyses and proposals

• • Documents produced by Cittadinanzattiva
    • “HTA applied to choices in healthcare companies. Results of some interviews “ (2015)
    •  “The relevance of civic organizations in HTA processes. Towards Civic Recommendation ” (2015)
    •  “Health Technology Assessment and civic organizations. Guidelines for the intervention ” (2014)
  • Documents in which there is a contribution from Cittadinanzattiva
    • “THE AdHopHTA HANDBOOK. A handbook of hospital-based health technology assessment” (2015)
    • “Adapted HTA REPORT. Screening for lung cancer ” (2014)
    • “Patient Involvement in Health Technology Assessment” (2017)
  • Publications in specialized journals
    • (TIJPH-Textbooks of the Italian Journal Of Public Health - 2017, Volume 6, Number 5)

2. Training activities through the “School for civic leaders on Health Technology Assessment”
   The School for civic leaders on Health Technology Assessment, created starting from 2012 by Cittadinanzattiva with the collaboration and support of Age.Na.S. FIASO and SiHTA, represents the first experience in Italy of training on HTA aimed exclusively at leaders of citizen and patient organizations, with the objective of promoting the development of a community that is committed to promoting the involvement of a competent “civic” component within the health technology assessment processes.

• • Since 2012, School for civic leaders on Health Technology Assessment (IT – EN)
    • 2012-I Edition, 2013-II Edition, 2014/2015-III Edition, 2016-IV Edition, 2017-V Edition
  • Patients' Involvement in HTA. Examples of program and training modules

3.  Institutional dialogue, stakeholder engagement and participation in working groups

• • At a national level
    • Ministry of Health Innovation Table - Control Room of the national HTA program of medical devices. Working group “Methods, training and communication”, subgroups:
      • Subgroup 1 (SG1) “Use and reuse of HTA assessment documents produced by international collaboration with the EUnetHTA network and standardization of the formats of assessment products and communication procedures”
      • Subgroup 3 (SG3) “Appraisal. Development and proposal of an appraisal process based on the most advanced scientific literature available on the subject and on experiences of proven efficacy”
    • Technical Scientific Committee of SIHTA - Italian Society of Health Technology Assessment
    • Member of the SIHTA Health Policy Forum - Italian Society of Health Technology Assessment
  • At an international level
    • Collaboration with Health Technology Assessment international (HTAi)
      • As it can be read from the official website of Cittadinanzattiva, at the end of 2012, after the first edition of the Summer School, Cittadinanzattiva joined the executive committee of the International Society for the involvement of citizens in the Health Technology Assessment. Read here (website in English).
      • HTAi: Working Groups
      • HTAi Annual Meeting (2017, in Rome)

4. Activities on the media (examples of interviews/editorials/position statements):

• • 50 reasons for a civic assessment of technologies
  • Nardi: self-monitoring to make up for deficiencies in chronic patient care
  • Rivaroxaban promoted by the Italian HTA evaluation
  • Beyond HTA to measure innovation. New cost-effective oral anticoagulants
  • Atrial fibrillation, now new oral anticoagulants

5. Participation in events as speakers (examples): 

• • HTAi’s 14th Annual Meeting (June 2017)
  • 3rd WHO Global Forum on Medical Devices (May 2017)
  • The Future of HTA in the European Union. From national best practices to EU cooperation (Feb. 2017)
  • 9° Sihta National Congress (Oct. 2016)
  • 8° Sihta National Congress (Oct. 2015)
  • 7° Sihta National Congress (Sept. 2014)

(last update: October 2017)