DECISION MAKING IN HEALTH SYSTEMS WORLDWIDE: AN OVERVIEW REFLECTING INNOVATIONS, OPPORTUNITIES AND CHALLENGES

Innovations and new health technology can significantly improve the clinical practice, health outcomes, and life expectancy. However, governments must make a decision about which intervention is of the best value,offers the best improvement in terms of health gain, fewer adverse events, and all of that in the frame of therestricted resources. Exploring the literature we can see that by using decision-making science and Healthtechnology assessment (HTA) a lot of countries had achieved the balance in the innovative health care world. Their approaches, framework, and development give us an insight of limitations and strengths that decision-makers and HTA agencies face to assess and optimize outcomes and the benefit-harm balance of new medicines and diagnostic tools. Bringing HTA in countries in development is also a concern that has economic and political restrictions and it raises a lot of questions and challenges for development of decision making sciences itself. Our findings suggest that within all the limitations and future challenges that are to come and even we do not have the perfect information, decision must be made. In most health care situations clinical and economic evidence must be extrapolated through time or space, transferred from one study to another, or combined and linked in a way that they can demonstrate a balance between the costs and consequences and capture the benefits of new technologies, overcome uncertainties, and recognize the value of innovation, all within the limits ofoverall health resources and constrained health budgets of the respective country