Decision makers in health care systems are facing the challenge of rising health care costs all over the world. Many interventions and technologies currently in use have never been systematically assessed regarding effectiveness, cost-effectiveness and safety. Active identification of ineffective interventions and technologies is thus gaining importance in order to both facilitate the best possible use of limited resources and provide effective and safe care for patients.

We have conducted a systematic review and analysis of internationally implemented models and strategies for the identification of ineffective interventions and technologies. Eight already implemented models and strategies were identified. The analysis showed that there are commonalities concerning objectives, stakeholder involvement and choice of target group as well as methods used for identification, prioritisation and assessment of ineffective interventions and technologies. Recommendations are disseminated via internet and implemented either as binding guidelines or as non-binding information for physicians and other stakeholders by the majority of models included. Based on the models analysed, a potential model for the Austrian context was developed.

Several challenges could be derived from the analysis of the models and strategies included. These challenges concern the models’ dependency on evidence regarding effectiveness, safety and cost-effectiveness. Further challenges are the absence of clear definitions, lacking acceptance by physicians and other stakeholders as well as scarce political support. Currently, there is not enough data to appraise the actual impact of the models and strategies included.