were identified with 90% from West Europe. HB-HTA reports were mainly prepared by academic centres (65%) followed by governmental organisations (18%) and less than 10% of the reports by hospital networks. Therapeutic procedures were most commonly evaluated (93%) with drugs constituting 76% of all reports. Clinical analyses were provided by 71% of reports while 68% and 34% reports included economic evaluations and budget impact analyses, respectively. Majority of decisions were positive or conditionally positive (20 and 32%, respectively), however almost 1/3 of reports were nonconclusive. Conclusions: HB-HTA is an established approach in decision making practice and needs an effective implementation to facilitate faster and more tailored uptake of technologies.

No abstract

likely to delay access to rare disease and oncology therapies. Though more opaque in how assessments translated to reimbursement, interviewees noted a preference for the "added clinical benefit" VAFs in France and Germany, compared with ICERbased VAFs. ConClusions: The innovative biopharmaceutical industry recognizes relative advantages and drawbacks of established VAFs, and its assessments are supported by empiric reimbursement outcomes across therapeutic areas. Countries interested in attracting multinational pharmaceutical investment and products should understand the nuances and lessons of established systems before imposing new VAF processes.