HTA Quarterly | Spring 2020

By Xcenda

In this issue, our editors examine the patient voice in HTA, updates to the ICER and NICE frameworks, and the changing healthcare landscape in India with the adoption of their own HTA. 


Integration of Patient-Reported Outcomes (PROs) and the Patient Voice: A Review of 6 Health Technology Assessment (HTA) Agencies

In recent years, some health technology assessment (HTA) agencies have been utilizing patient-reported outcome (PRO) instruments and inclusion of the patient voice when evaluating pharmacotherapies or medical technologies. While inclusion of PROs and/or patient voice within an HTA can have a positive influence on recommendations, inconsistencies in terms of how this information is collected across HTA agencies and across different assessments within the same HTA agency is problematic for manufacturers. The differing value of PROs and patient voice by country is strongly reflected by the respective processes of HTA agencies’ assessments. This article provides a brief overview as to how the patient voice and/or PROs are utilized in HTA decision making within Australia, Canada, Germany, Sweden, the United Kingdom, and the United States.
Patient and doctor


A Tale of 2 Frameworks: Impact of ICER and NICE Updates on Future HTAs and Market Access

The National Institute for Health and Care Excellence (NICE) and the Institute for Clinical and Economic Review (ICER) are recognized health technology assessment (HTA) bodies that independently conduct economic evaluations of healthcare interventions by comparing clinical efficacy and safety, estimating incremental cost-effectiveness of one or more interventions relative to a common comparator, and providing determinations regarding the value of a treatment in terms of the cost per quality-adjusted life-year (QALY) gained. Methodologies utilized by NICE and ICER need to be regularly updated to stay relevant. What implications will these updates have on manufacturers looking to commercialize health technologies in these markets over the next several years, and what is the impact on evidence generation requirements? This article examines and compares the current and forthcoming method updates to help shed light on these questions.
Oral medication with pricing data and a calculator


How the Adoption of Health Technology Assessment Is Changing the Healthcare Landscape of India

India is one of the fastest-growing economies in the world, with healthcare becoming one of its largest sectors in terms of both revenue and employment. India’s healthcare sector continues to grow at a rapid pace, largely driven by rising incomes, increased access to insurance, and significant advances in its healthcare infrastructure. Despite substantial growth, India’s healthcare sector still has much room for improvement. This article will examine India's new institution, Health Technology Assessment in India (HTAIn), and how it will change the current healthcare landscape.
Flag of India in capsule

Heard on the Street

“CADTH is pleased to announce the formation of the Pharmaceutical Advisory Committee, a new advisory body that will provide strategic advice to CADTH on drug-related issues and topics. This committee has been formed through the merger of the Drug Policy Advisory Committee and the pCODR [pan-Canadian Oncology Drug Review] Advisory Committee. Consolidation of these committees will offer efficiency for both CADTH and the participating jurisdictions. CADTH wishes to thank all jurisdictional representatives who served on the previous advisory committees for their contributions.”

– CADTH (Canadian Agency for Drugs and Technologies in Health) news release

HTA by the Numbers


Haute Autorité de Santé (HAS) published an action plan for innovative medicines that contains 6 points. The aim of this action plan is to appropriately balance the need for access to potentially high-value, innovative therapies which often have uncertainty around the clinical benefit as a result of short clinical developments, on small samples of patients. These 6 points include:

  1. Make conditional opinions, time to resolve uncertainties
  2. Track medications in real life to verify initial promises
  3. Strengthen the agility of HAS to better support innovation
    1. Focus on high added-value assessments
    2. Develop early meetings to support clinical developments
    3. Promote accelerated (so-called “fast-tracking”) assessment procedures
    4. Improve collective efficiency
  4. Systematically involve patients and users
  5. Strengthen transparency
    1. On time
    2. On post-registration studies
  6. Strengthen European cooperation to pool knowledge

Source: La HAS présente son plan d’action pour les médicaments innovants