A different animal? Identifying the features of health technology assessment for developers of medical technologies

Abstract

Health technology assessment (HTA) conducted to inform developers of health technologies (development-focused HTA, DF-HTA) has a number of distinct features when compared to HTA conducted to inform usage decisions (use-focused HTA). To conduct effective DF-HTA, it is important that analysts are aware of its distinct features as analyses are often not published. We set out a framework of ten features, drawn from the literature and our own experience: a target audience of developers and investors; an underlying user objective to maximize return on investment; a broad range of decisions to inform; wide decision space; reduced evidence available; earlier timing of analysis; fluid business model; constrained resources for analysis; a positive stance of analysis; and a “consumer”-specific burden of proof. This paper presents a framework of ten features of DF-HTA intended to initiate debate as well as provide an introduction for analysts unfamiliar with the field.

A toolkit of methods of development-focused health technology assessment

“…Health Technology Assessment (HTA) conducted to inform decision making during the development of health technologies, which we term “development-focused HTA” (DF-HTA), has a number of distinct features when compared with HTA conducted to inform reimbursement and usage decisions (use-focused HTA). We have described these features in a previous article (1). These features may influence the selection of appropriate methods for DF-HTA.…”

“…We present a toolkit of methods for the DF-HTA analyst to use at different stages of a research and development process. We hope it will be used in conjunction with the framework of features of DF-HTA presented in our earlier article (1) in order to improve the clarity and appropriateness of methods used in DF-HTA. We also seek to contribute to a dialogue about the nature of, and the best approach to undertaking, DF-HTA.…”

A different animal but the same beast? Using development-focused health technology assessment to define the value proposition of medical technologies

“…To the Editor: I read the article "A different animal? Identifying the features of health technology assessment (HTA) for developers of medical technologies" by Bouttell et al (1) with great interest. The authors provide a useful framework for development-focused HTA (DF-HTA).…”

“…Unavoidably, the authors miss a great opportunity with the proposed framework to bring synergy to the alignment of value proposition in the innovation ecosystem. Particularly in the UK, the upcoming MedTech Funding mandate and other initiatives developed by the Accelerated Access Collaborative offer new opportunities to test in practice and iterate the usefulness of DF-HTA frameworks such as the one proposed by Bouttell et al (2020).…”

The thorny issue of value alignment: how development-focused health technology assessment can help find win–win situations for patients and healthcare systems and commercial investors

“…We thank Anastasia Chalkidou for her thoughtful response to our recent article “A different animal? Identifying the features of health technology assessment for developers of medical technologies” (1). Dr. Chalkidou considers that we missed an opportunity in our framework to attempt to reconcile the tension between the interests of commercial innovators on the one hand and patients and healthcare systems on the other (2).…”