Abstract
New forces on the political landscape, rooted largely in the economics of medical care, are pressing federal officials and private interests to develop more adequate mechanisms to assess the safety and efficacy of emerging medical technologies. One force stems from expressed congressional concern over the resistance of some third-party payers to finance liver transplantation because, the payers argue, its efficacy has not been sufficiently well demonstrated. A second force is represented by a draft report of an Institute of Medicine committee, which recommends creation of a private–public technology-assessment body. A third force, which will probably prove to be the most . . .

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