To be fit for future needs, HTA systems and processes need to evolve over time, taking into account increasing demand, technological advances and emerging evidence on societal preferences.
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November 2024
Guest editor: Martina Garau | Director
To be fit for future needs, HTA systems and processes need to evolve over time, taking into account increasing demand, technological advances and emerging evidence on societal preferences.
A recent OHE report shows that HTA agencies have become increasingly transparent in the method and position they adopt on a number of topics. For example, most HTA agencies have embraced the consideration of more modifiers over time, signalling the importance of prioritising treatment for severe conditions in resource allocation decisions.
Our report also shows that NICE was one of the first HTA systems to
introduce an explicit and quantitative modifier for severity. However, a new OHE report finds that NICE’s current severity modifier is not well aligned with public preferences in England and Wales. We found the public assigns greater value to health gains at lower levels of severity than NICE’s modifier. This suggests NICE may need to reassess its criteria in line with societal preferences, and demonstrates the need for HTA systems to adapt their methods when new evidence emerges. David Mott, a senior principal economist at OHE, was quoted in Bloomberg News on the report, which was also referred to in the article.
International HTA collaborations (such the Joint Nordic HTA-Bodies and the so-called Commonwealth collaboration) represent a valuable route to accelerate changes and drive convergence between HTA guidelines and practice. A recent blog argues that to be successful they need to be well aligned with collaborations with regulatory agencies and ensure that initiatives with the most significant impact on healthcare systems and patient outcomes are prioritised.
The introduction of innovative approaches is also needed at other stages of the access pathways of new interventions. For instance, the lack of accepted pricing models in Europe represents a barrier to access for combination therapies. An upcoming OHE webinar will explore arguments in favour and against value-aligned pricing in the context of combination therapies, whereby differential payments are agreed according to the value generated by the treatments in different uses.
New Publication
Understanding societal preferences for priority by disease severity in England & Wales
NICE’s current severity modifier, which prioritises treatments for severe diseases, appears misaligned with public preferences in England and Wales.
The public values prioritizing health gains at lower severity thresholds and assign greater value at nearly all levels of severity compared to NICE’s standards.
Should NICE reconsider its criteria to better align with societal preferences?
How Have HTA Agencies Evolved Their Methods Over Time?
Health Technology Assessment (HTA) methods have evolved, showing an increase in detailed guidelines across different agencies.
While many agencies have adapted to include extended guidance on topics such as discount rates and real-world evidence, others still lack explicit frameworks.
Could increased international collaboration be the key to harmonising HTA methods and more consistent, timely reforms?
Is collaboration between and across regulatory and HTA agencies the answer to access challenges?
In recent years, collaborative initiatives between regulatory and HTA agencies have been pivotal in improving the efficiency of healthcare decision-making systems.
These collaborations, whether horizontal among similar agencies or vertical between regulatory and HTA bodies, aim to streamline processes from clinical development to reimbursement.
Yet, the question remains: are these collaborations fully delivering on their promises to improve access challenges?
