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Karbon Salımının Sağlık Teknolojileri Değerlendirmesine Dâhil Edilmesi

Yıl 2026, Cilt: 28 Sayı: 1 , 345 - 374 , 20.04.2026
https://doi.org/10.26745/ahbvuibfd.1809502
https://izlik.org/JA56YW56KB

Öz

Geleneksel sağlık teknolojisi değerlendirme (STD) yaklaşımları çoğunlukla klinik ve ekonomik kriterlere odaklanırken, çevresel sürdürülebilirlik unsurlarını göz ardı etmektedir. Çevresel etkilerin, özellikle karbon salımının STD süreçlerine entegrasyonu hem yöntem hem de etik, politik ve yönetim açısından çok katmanlı bir değerlendirme gerektirmektedir. Bu çalışma, mevcut yöntemlerin sınırlılıklarını ve uygulanabilirliğini analiz ederek, karbon salımının STD’de nasıl dikkate alınabileceğini tartışmaktadır. Karbon salımının STD’ye dahil edilmesi için, karbonun sosyal maliyeti doğrudan maliyet-etkililik hesaplarına dahil edilebilir ya da karbon salımı bilgisi maliyet-etkililik dışında ek bir ölçüt olarak ele alınabilir. Araştırmalar bu yöntemlerin önündeki temel engelleri ortaya koymaktadır; veri eksiklikleri, standartlaştırma sorunları ve uygulanabilirlik zorlukları. Ancak bu zorluklar aşılabilir niteliktedir. Çevresel etkilerin STD süreçlerine dahil edilmesi, artık sağlık sistemlerinin sürdürülebilirliği için bir zorunluluktur. Uluslararası düzeyde NICE, ICER ve HAS gibi kurumların çevresel etkileri değerlendirme süreçlerine dahil etmeye başlasa da bu çabaların henüz kurumsal standartlara dönüşmediği gözlemlenmektedir. Türkiye özelinde ise, çevresel etkilerin STD politikalarına sistematik biçimde dahil edilmediği, ancak 2053 Net Sıfır Emisyon hedefi ve Avrupa Yeşil Mutabakatı çerçevesinde bu yönde bir dönüşüm olanağı bulunduğu belirtilmektedir. Sonuç olarak, çevresel etkilerin STD süreçlerine dahil edilmesi, sağlık sistemlerinin sürdürülebilirliği açısından stratejik bir gereklilik olarak ortaya çıkmakta; bunun sağlanabilmesi için standart yöntemlerin geliştirilmesi, veri altyapısının güçlendirilmesi ve karar vericiler arasında farkındalık oluşturulması gerektiği ifade edilmektedir.

Kaynakça

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Integration of Carbon Emissions into Health Technology Assessment

Yıl 2026, Cilt: 28 Sayı: 1 , 345 - 374 , 20.04.2026
https://doi.org/10.26745/ahbvuibfd.1809502
https://izlik.org/JA56YW56KB

Öz

Traditional health technology assessment (HTA) approaches primarily focus on clinical and economic criteria, often overlooking aspects of environmental sustainability. The integration of environmental impacts—particularly carbon emissions—into HTA processes requires a multilayered evaluation in methodological, ethical, policy, and governance dimensions. This study discusses how carbon emissions can be incorporated into HTA by analyzing the limitations and applicability of current methods. To incorporate carbon emissions into HTA, the social cost of carbon can be directly included in cost-effectiveness calculations, or carbon emission data can be considered as an additional criterion beyond cost-effectiveness. Research highlights key obstacles to these methods, including data deficiencies, standardization issues, and challenges in practical implementation. However, these challenges are surmountable. Including environmental impacts in HTA has become a necessity for the sustainability of healthcare systems. Although institutions such as NICE, ICER, and HAS have begun integrating environmental considerations into their assessment processes at the international level, these efforts have yet to evolve into institutional standards. In the case of Türkiye, environmental impacts have not yet been systematically incorporated into HTA policies, but the 2053 Net Zero Emissions target and the European Green Deal present a potential pathway for transformation. In conclusion, incorporating environmental impacts into HTA processes is emerging as a strategic imperative for the sustainability of health systems. Achieving this requires the development of standardized methods, strengthening of data infrastructure, and raising awareness among decision-makers.

Kaynakça

  • Abdali Z, Avşar TS, Jowett S, Syed M, Elmusharaf K, Jackson L. Decision-analytical modelling of medicines in the Middle East: a systematic review of economic evaluation studies. Appl Health Econ Health Policy. 2025; 23(4): 569-612. doi: 10.1007/s40258-024-00940-x.
  • Alajärvi L, Lehtimäki AV, Timonen J, Martikainen J. Willingness to pay for implementation of an environmentally friendly pharmaceutical policy in Finland-A discrete choice experiment study. Int J Environ Res Public Health. 2022;19(11):6535. doi: 10.3390/ijerph19116535
  • Allen MR, Dube OP, Solecki W, Aragón-Durand F, Cramer W, Humphreys S, et al. Framing and Context. In: Masson-Delmotte V, Zhai P, Pörtner H-O, Roberts D, Skea J, Shukla PR, et al., editors. Global Warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty. Cambridge (UK) and New York (NY): Cambridge University Press; 2018. p. 49–92. doi:10.1017/9781009157940.003.
  • Andersen MP, Blom L, Kiritharakopalan N. The environmental benefits of telemedicine: A review of carbon savings across health systems. J Telemed Telecare. 2023;29(4):198–210. doi:10.1177/1357633X231153279.
  • Avşar TS, Yang X, Lorgelly P. How is the societal perspective defined in health technology assessment? Guidelines from around the globe. Pharmacoeconomics. 2023;41(2):123–38. doi:10.1007/s40273-022-01221-y. 6. Bambha K, Kim WR. Cost-effectiveness analysis and incremental cost-effectiveness ratios: uses and pitfalls. Eur J Gastroenterol Hepatol. 2004; 16(6): 519-26. doi: 10.1097/00042737-200406000-00003.
  • Banta D. The development of health technology assessment. Health Policy. 2003;63(2):121–32. doi:10.1016/S0168-8510(02)00059-3.
  • Banta D. What is technology assessment? Int J Technol Assess Health Care. 2009; 25 Suppl 1: 7-9. doi: 10.1017/S0266462309090333.
  • Bobini M, Cicchetti A. Integrating environmental sustainability into health technology assessment: an international survey of HTA stakeholders. Int J Technol Assess Health Care. 2024;40(1): e64. doi:10.1017/S0266462324000631.
  • Bressler RD, Moore FC, Rennert K, Anthoff D. Estimates of country level temperature-related mortality damage functions. Sci Rep. 2021;11(1):20282. doi:10.1038/s41598-021-99156-5.
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  • Pekarsky BAK. The inclusion of comparative environmental impact in health technology assessment: practical barriers and unintended consequences. Appl Health Econ Health Policy. 2020;18(5):597-9. doi:10.1007/s40258-020-00578-5.
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  • Pinho-Gomes AC, Yoo SH, Allen A, Maiden H, Shah K, Toolan M. Incorporating environmental and sustainability considerations into health technology assessment and clinical and public health guidelines: a scoping review. Int J Technol Assess Health Care. 2022; 38(1): e84. doi: 10.1017/S0266462322003282.
  • Polisena J, De Angelis G, Kaunelis D, Gutierrez-Ibarluzea I. Environmental impact assessment of a health technology: A scoping review. Int J Technol Assess Health Care. 2018;34(3):317–326. doi:10.1017/S0266462318000349.
  • Pongsiri MJ, Roman J, Ezenwa VO, Goldberg TL, Salkeld DJ, Carroll DS. The need for a systems approach to planetary health. Lancet Planet Health. 2019;3(5): e192–3. doi:10.1016/S2542-5196(19)30018-9.
  • Rennert K, Errickson F, Prest BC, Rennels L, Newell RG, Pizer W, et al. Comprehensive evidence implies a higher social cost of CO₂. Nature. 2022; 610(7933): 687-92. doi: 10.1038/s41586-022-05224-9.
  • Rudmik L, Drummond M. Health economic evaluation: important principles and methodology. Laryngoscope. 2013; 123(6): 1341-7. doi: 10.1002/lary.23943.
  • Sherman JD, Raibley LA, Eckelman MJ. Life cycle assessment and costing methods for device procurement: Comparing reusable and single-use disposable laryngoscopes. Anesth Analg. 2012;114(5):1067–1076. doi:10.1213/ANE.0b013e318248f5e6.
  • Szawara P, Chu J, Lekhwar P, Dimitrova L, Wagner P, van Engen A, et al. Environmental sustainability in HTA: are HTA bodies applying environmental criteria in their decision-making? Poster presented at: ISPOR Europe 2023; 2023 Nov; Copenhagen, Denmark. IQVIA.
  • T.C. Çevre, Şehircilik ve İklim Değişikliği Bakanlığı. 2053 yılı itibarıyla net sıfır emisyon hedefini gerçekleştirmeyi öngörüyoruz [Internet]. 2023 [cited 2025 May 13]. Available from: https://iklim.gov.tr/2053-yili-itibariyla-net-sifir-emisyon-hedefini-gerceklestirmeyi-ongoruyoruz-haber-4173
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Toplam 75 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Yönetimi
Bölüm Derleme
Yazarlar

Tuba Saygın Avsar 0000-0002-4143-3852

Selin Kalender 0000-0002-4377-9339

Meryem Koçaş 0000-0002-7891-6866

Aliye Kübra Ünal 0000-0002-6730-7686

Gizem Özargun 0000-0002-0777-2770

Gönderilme Tarihi 24 Ekim 2025
Kabul Tarihi 10 Nisan 2026
Yayımlanma Tarihi 20 Nisan 2026
DOI https://doi.org/10.26745/ahbvuibfd.1809502
IZ https://izlik.org/JA56YW56KB
Yayımlandığı Sayı Yıl 2026 Cilt: 28 Sayı: 1

Kaynak Göster

APA Saygın Avsar, T., Kalender, S., Koçaş, M., Ünal, A. K., & Özargun, G. (2026). Karbon Salımının Sağlık Teknolojileri Değerlendirmesine Dâhil Edilmesi. Ankara Hacı Bayram Veli Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 28(1), 345-374. https://doi.org/10.26745/ahbvuibfd.1809502