The Law of Cohering and Quality of the National Health System (16/2003) (2) envisages the exclusion of a technique, technology or procedure included in the common service portfolio of the National Health System, where one or more of the following circumstances is present:
The Royal Decree 1030/2006 considers these circumstances (3) and the Ministry of Health & Consumer Affairs Order (Orden SCO) 422/2007 of 21 November (4), which lays down the procedure for updating the common service portfolio of the National Health System, envisages the exclusion of technologies in the above-mentioned cases.
Some regional enactments, such as those of Galicia or the Basque Country Autonomous Region also provide, albeit not on a mandatory basis (5, 6), that in cases where the updating of the service portfolio is proposed, indication must be given as to any potential technologies that are going to be replaced when the new technology is introduced, thereby indirectly raising the obsolescence of technologies that are already in place. Similarly, the technology acquisition guideline of the Andalusian Health Technology Assessment Agency (Guía para la Adquisición de Nuevas Tecnologías en los Centros Sanitarios de Andalucía – GANT) envisages the possibility of identifying technologies that have been completely superseded by others (7).
Hence, in Spain there is a statutory framework that envisages the possibility of obsolete health technologies existing and these being excluded from the service portfolio through withdrawal of their funding. A system for identifying, prioritising and assessing potentially obsolete HTs would bolster this legal provision, thereby making it possible for citizens to receive the most appropriate health care and, moreover, for available resources to be allocated more efficiently. In addition, a great advantage of this system is that it would allow for rigorous assessment of scientific evidence on the efficacy and safety of a potentially obsolete technology.