Environmental Sustainability in Health Technology Assessment (ESHTA) Working Group
Established in June 2024 (currently active)
Leaders
Melissa Pegg
University of York, United Kingdom (melissa.pegg@york.ac.uk)
Jani Mueller
HTAi Vice President (jmueller@htai.org)
Nicola McMeekin
University of Glasgow, United Kingdom
Members
- Rosalie Ardent, The Netherlands
- Heidi Barnard, United Kingdom
- Paul Broadberry, United Kingdom
- Edward Clifton, United Kingdom
- Rossella Di Bidino, Italy
- Caroline Farmer, United Kingdom
- Janneke Grutters, The Netherlands
- Grace Hampson, United Kingdom
- Sarin K, Thailand
- Addie MacGregor, United Kingdom
- Abhirup Mazumdar, India
- Maria Pinelli, Italy
- Pietro Refolo, Italy
- Koonal Shah, United Kingdom
- Matthew Taylor, United Kingdom The Netherlands
- Koonal Shah, United Kingdom
- Caroline Farmer, United Kingdom
- Matthew Taylor, United Kingdom
- Edward Clifton, United Kingdom
- Rosalie Ardent, The Netherlands
- Paul Broadberry, United Kingdom
- Addie MacGregor, United Kingdom
- Grace Hampson, United Kingdom
- Heidi Barnard, United Kingdom
- Abhirup Mazumdar, India
- Rossella Di Bidino, Italy
- Pietro Refolo, Italy
- Sarin K, Thailand
Advisory Board members
- Leon Bijlmakers, The Netherlands
- Chiara de Waure, Italy
- Katrine Fronsdal, Norway
- Ken Goodman, United States of America
- Ranieri Guerra, Italy
- Inaki Gutierrez Ibarluzea, Spain
- Grace Huang, Taiwan
- Dimtra Lingri, Greece
- Anke Peggy Holtorf, Switzerland
- Dimitra Panteli, Belgium
- Elena Petelos, Greece
- Alric Rüther, Germany
- Uwe Siebert, Austria
- Rabia Sucu, United States of America
- Laura Bojke, United Kingdom
Overview
HTA plays a key role by integrating environmental sustainability—defined as the capacity to meet human needs without exceeding ecosystem limits or harming biodiversity—into its evaluations.The new definition of HTA widens scope to include environmental criteria, though these remain underdeveloped in current reference frameworks. Key challenges include identifying relevant criteria, defining assessment boundaries, ensuring data quality, and addressing trade-offs between health and sustainability outcomes.Potential solutions include applying environmental life‑cycle assessment, One Health and circular economy frameworks, and system sustainability models—aligned with HTA principles—to advance sustainable development across the health technology life cycle.
The ESHTA Working Group brings together regulators, providers, payers, policymakers, researchers, patients, and industry to strengthen methods and frameworks for integrating environmental sustainability into HTA. We welcome new members committed to advancing this essential work.
Purpose
- To define the role of HTA in relation to environmental sustainability.
- To define the scope for environmental sustainability in HTA.
- To propose value frameworks that incorporate environmental sustainability and its operationalization thereof.
- To foster consensus on such approaches, providing feasible and comprehensive solutions that can be piloted and implemented to achieve environmental sustainability recommendations in HTA.
The WG has the following work streams:
- Work Stream 1: Definitions and terminology for environmental sustainability in HTA
- Work Stream 2: International policies for environmental sustainability in healthcare
- Work Stream 3: Evaluation of methods for environmental sustainability in HTA
Deliverables
The New Definition of Early Health Technology Assessment: Implications for Incorporating Environmental Sustainability
Pegg M, Kc S, Majumdar AD, Grigolo S, Kapper J, Taylor MHG.
International Journal of Technology Assessment in Health Care. Published online July 21, 2025:1-12.
Toward including environmental sustainability in Health Technology Assessment.
Holtorf AP, Pegg M, Mueller D, McMeekin N, HTAi (ESHTA).
International Journal of Technology Assessment in Health Care. 2025;41(1):e70.
Other resources and material
Zotero Group Library “ESHTA – Environmental Sustainability in Health Technology Assessment”