Can a health professional represent patient views: industry response.

To the Editor: The writer raises some interesting points. It is evident the “health professional as patient” faces several challenges that are of a general nature and not specific to Health Technology Assessment processes. As she articulates, the “health professional as patient” may be faced with a range of responses including the assumption that the “patient” knows everything relevant to their condition and does not need support, or somehow feeling the health professional has “let the side down” by becoming a patient. In regard to HTA processes specifically, there is increasing recognition of the importance of quality, balanced input from patients, patient advocates, and in some situations, carers. The fact that the health professional concerned may, by virtue of professional knowledge and experience, have an advantage in expressing that input should not be seen as a reason for preventing or ignoring that input. On the contrary, provided the HTA process seeks and uses patient (and carer) perspectives for the right reasons, this should be a positive. The “right reasons” include gaining a more thorough understanding of what it is like to live with the condition in question, clarifying what changes in disease-specific outcome measures really mean, and the strengths and disadvantages of current treatments. Conducted with these objectives in mind, patient and public perspectives can be a positive contribution to good HTA. There is no place for the “this treatment must be recommended because I need it” style of input. Indeed, that can be seen on occasions from health professionals and patients alike. What is needed is a positive and supportive HTA process that makes clear what input is desired from both patients and health professionals, and how that will be used. When this is operating and individuals understand what is useful, they should feel that their input is both welcome and valuable to the HTA process and its outputs. From an industry perspective, our desire is to see the full range of perspectives considered in HTA processes, with objective assessment that considers all stakeholders views and inputs. This requires a transparent system and education for all stakeholders, including patient advocates and interested health professionals.