To the Editor: We read with interest the recent editorial and articles on health technology assessment.1-4 We are pleased that the Journal highlighted this important policy process that attempts to ensure that technologies that improve health gain or health care are supported and those that do not contribute to an improved outcome are not supported.

The description of HealthPACT in the editorial1 is not quite accurate in that HealthPACT is a subcommittee of the Medical Services Advisory Committee (MSAC). Its funding comes through MSAC with some supplementation from the Australian Health Ministers’ Advisory Committee. The techniques of early detection and horizon scanning have been developed, and the results of this work are available to the health community of Australia, be it jurisdictional, public, private or specialised. In particular, if promising health care technologies are identified through this process, they are referred to MSAC for a full health technology assessment, thus ensuring that appropriate technologies are identified as early as possible in the technology cycle and are assessed by MSAC for introduction into the health care system.

This horizon-scanning activity does not currently involve drugs or vaccines, and the Australian health care system could benefit from this process, just as the National Institute for Health and Clinical Excellence in the United Kingdom and the Canadian Agency for Drugs and Technologies in Health undertake comprehensive horizon scanning.

With respect to conflicts of interest, MSAC is very specific at all levels of its operation. At the commencement of every advisory panel and MSAC meeting, the Chair requests declaration of conflicts of interest. These are recorded in the minutes and appropriate decisions are made on the participation of the person declaring a conflict based on an assessment of the issue.

This is formal and explicit, and is on the public record. It is important to state this, as the article by Petherick and colleagues implies that MSAC does not record conflicts of interest.4 In fact, MSAC places great importance on declaration of conflicts of interest.