Karbon Salımının Sağlık Teknolojileri Değerlendirmesine Dâhil Edilmesi

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.

Anahtar Kelimeler

• karbon salımı
• karbon emisyonu
• sağlık teknolojisi değerlendirmesi
• ekonomik değerlendirme.

Integration of Carbon Emissions into Health Technology Assessment

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.

Anahtar Kelimeler

• carbon footprint
• carbon emissions
• health technology assessment
• economic evaluation.

Kaynakça

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