The evaluation of medicines and medical technologies – also called Health Technology Assessment (HTA) – underpins market access, price negotiations and reimbursement policies of health technologies. In Europe, HTA is characterised by a diversity of methodologies and practices. European HTA networks have sought to establish a sustainable cooperation framework to reach convergence. This process has led to a European Commission proposal for a Regulation in HTA cooperation which adoption process is still running.

HTA cooperation has been analysed in relation to European health policy. As EU competences regarding HTA are limited to support-lending and coordination policies, the thesis has examined to what extent cooperation and convergence of European HTA practices can be structured through soft governance applied in networks. Factors favouring convergence in this area have been identified. The conclusions of this thesis bring to the fore that soft governance, by offering flexibility and gradualism, can be a powerful instrument to instil convergence in policy areas of limited EU competences. Lack of effectiveness of soft governance in HTA cooperation processes has been attributed to the manner in which soft governance instruments have been implemented rather than inherent weaknesses of soft governance itself.

The thesis points to the importance of active participation of domestic policymakers and senior representatives of HTA bodies in similar cooperation processes as well as a transparent inclusive stakeholder policy and European legislative frameworks allowing for the development of flexible cooperation structures. The role of soft governance in EU integration policies could be conceived as a real alternative to classic modes of integration.

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A. Boer (Albert) , prof.dr. R. Harmsen (Robert)
Erasmus University Rotterdam
Health Care Governance (HCG)