Taking Patient Heterogeneity and Preferences Into Account in Health Technology Assessments

Kievit, Wietske; Tummers, Marcia; Hoorn, Ralph van; Mozygemba, Kati; Refolo, Pietro; Sacchini, Darío; Pfadenhauer, Lisa M.; Gerhardus, Ansgar; Wilt, Gert Jan van der

doi:10.1017/s0266462317000885

Cited by 24 publications

(30 citation statements)

References 28 publications

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“…At the European level, the INTEGRATE-HTA project, cofounded by the European Union (EU), was dedicated to improving HTA methodologies to better fill in gaps that health authorities were missing in order to better build patient-centric solutions (45). The project which ended in December 2015 promoted inclusion of various backgrounds and stakeholders, including patients, and emphasized patient heterogeneity as an area of exploration (45). The INTEGRATE-HTA project also highlighted the current shortcomings of PP inclusion with relation to HTA and economic evaluations, such as costeffectiveness (45).…”

Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

“…The project which ended in December 2015 promoted inclusion of various backgrounds and stakeholders, including patients, and emphasized patient heterogeneity as an area of exploration (45). The INTEGRATE-HTA project also highlighted the current shortcomings of PP inclusion with relation to HTA and economic evaluations, such as costeffectiveness (45). Moreover, the INTEGRATE-HTA project acknowledged that PP elicitation, assessment, and integration in decision making may also empower acceptability of health policy decisions and enhance the transparency of the decision-making processes (45).…”

Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

“…The INTEGRATE-HTA project also highlighted the current shortcomings of PP inclusion with relation to HTA and economic evaluations, such as costeffectiveness (45). Moreover, the INTEGRATE-HTA project acknowledged that PP elicitation, assessment, and integration in decision making may also empower acceptability of health policy decisions and enhance the transparency of the decision-making processes (45). Lastly, the ongoing IMI PREFER project and EUPATI patients' training modules and guidance have also been working on tools and recommendations for use of PPs within the HTA process at the European level (3, 10, 12).…”

Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

“…By anticipating PP and being able to understand the actual real-world benefits and harms of these therapies, complemented with the efficacy data provided by clinical evidence, health authorities may be able to make more efficient and effective decisions with regard to pricing and reimbursement as well as targeting of the optimal subgroups most likely to benefitfurther enhancing the effectiveness of these therapies (45). In fact, the International Network of Agencies for Health Technology Assessment (INAHTA) conducted a survey in 2006 which revealed that including patients in these critical decision-making processes with health authorities expands the perspective and information available for the assessments and provides greater advice to them (8).…”

Section: Importance Of Incorporation and Consideration Of Pps In Polimentioning

confidence: 99%

“…Another aspect or potential obstacle for these studies that has not been thoroughly studied, yet merits further exploration, is the scope and expense of these studies. As patient-centric treatments and solutions will increasingly come to the market, the complexity of them and each additional attribute in the study of PP elicitation will be at a cost (45). The industry and decision makers will have to consider the cost of PP elicitation prior to engaging in any evaluation.…”

Section: Obstacles In Incorporation and Assessment Of Ppsmentioning

confidence: 99%

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Use of Patient Preference Information in Benefit–Risk Assessment, Health Technology Assessment, and Pricing and Reimbursement Decisions: A Systematic Literature Review of Attempts and Initiatives

et al. 2020

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Objectives: Inclusion of patient preference (PP) data in decision making has been largely discussed in recent years. Healthcare decision makers-regulatory and health technology assessment (HTA)-are more and more conscious of the need for a patient-centered approach to decide on optimal allocation of scarce money, time, and technological resources. This literature review aims to examine the use of and recommendations for the integration of PP in decision making. Methods: A literature search was conducted through PubMed/Medline in May 2019 to identify publications on PP studies used to inform benefit-risk assessments (BRAs) and HTAs and patient-centered projects and guidelines related to the inclusion of PPs in health policy decision making. After title and abstract screening and full-text review, selected publications were analyzed to retrieve data related to the collection, use, and/or submission of PPs informing BRA or HTA as well as attempts and initiatives in recommendations for PPs integration in decision-making processes. Results: Forty-nine articles were included: 24 attempts and pilot project discussions and 25 PP elicitation studies. Quantitative approaches, particularly discrete choice experiments, were the most used (24 quantitative elicitation studies and 1 qualitative study). The objective of assessing PPs was to prioritize outcome-specific information, to value important treatment characteristics, to provide patient-focused benefit-risk trade-offs, and to appraise the patients' willingness to pay for new technologies. Moreover, attempts and pilot projects to integrate PPs in BRAs and HTAs were identified at the European level and across countries, but no clear recommendations have been issued yet. No less than seven public and/or private initiatives have been undertaken by governmental agencies and independent organizations to set guidance targeting improvement of patients' involvement in decision making. Chachoua et al. Patient Preferences in Policy Decision-Making Conclusion: Despite the initiatives undertaken, the pace of progress remains slow. The use of PPs remains poorly implemented, and evidence of proper use of these data in decision making is lacking. Guidelines and recommendations formalizing the purpose of collecting PPs, what methodology should be adopted and how, and who should be responsible for generating these data throughout the decision-making processes are needed to improve and empower integration of PPs in BRA and HTA.

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Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

Section: Attempts and Initiatives In Htasmentioning

confidence: 99%

Section: Importance Of Incorporation and Consideration Of Pps In Polimentioning

confidence: 99%

Section: Obstacles In Incorporation and Assessment Of Ppsmentioning

confidence: 99%

See 3 more Smart Citations

Use of Patient Preference Information in Benefit–Risk Assessment, Health Technology Assessment, and Pricing and Reimbursement Decisions: A Systematic Literature Review of Attempts and Initiatives

et al. 2020

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Use of Patient Preferences in Health Technology Assessment: Perspectives of Canadian, Belgian and German HTA Representatives

Overbeeke

Forrester

Simoens

et al. 2020

Patient

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Objective Patient preferences can be informative for health technology assessment (HTA) and payer decision making. However, applications may be different per country. The aim of this study therefore was to investigate HTA representatives' opinions on whether and how to incorporate patient preferences in HTA in their respective countries. Methods Three country-specific focus groups were conducted with three to seven HTA representatives from Germany, Belgium, and Canada. A predefined focus group guide was used that covered topics relating to how patient preferences can be used in HTA, namely HTA stage, weight, impact, and quality, as well as a case example of gene therapy. Transcripts were analyzed using NVivo 12 following thematic analysis. Results Across all HTA bodies, an interest in the use of patient preferences was observed for scientific advice and value assessments, but not through incorporation in quality-adjusted life-years and multi-criteria decision analysis. HTA representatives found it difficult to determine the weight patient preferences may receive in decision making, but thought it could have an impact on payer decision making if the study is of acceptable quality. Conclusions In the near future it may be impossible to achieve structural integration of patient preferences with other evidence in HTA (e.g., in cost-effectiveness analysis), but HTA bodies are willing to incorporate patient preferences in other HTA sections as supportive evidence. To allow for that use, future work should focus on meeting HTA and payer needs when conducting patient preference studies and on education of HTA and payer representatives regarding these studies.

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The Impact of Video-Based Educational Materials with Voiceovers on Preferences for Glucose Monitoring Technology in Patients with Diabetes: A Randomised Study

Smith

Whichello

Bekker‐Grob

et al. 2023

Patient

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Introduction Ensuring patients have enough information about healthcare choices prior to completing a preference study is necessary to support the validity of the findings. Patients are commonly informed using text-based information with supporting graphics. Video-based information may be more engaging for the general patient population. This study aimed to assess (1) the impact that educating patients using video-based educational materials with a voiceover has on patient preferences compared to traditional text, and (2) whether this impact is consistent between two countries. Materials and Methods A video-based educational tool was developed to inform patients prior to completing a discrete choice experiment assessing preferences for glucose monitors. Patients with diabetes from the Netherlands and Poland were recruited through an online research panel. Respondents were randomised to receive information in either a text or a video with animations and a voiceover. Data were analysed using a mixed-logit model. Results N = 981 completed surveys were analysed from the Netherlands ( n = 459) and Poland ( n = 522). Differences were found between the countries, but no interpretable pattern of differences was found between the two types of educational materials. Patients spent less time in the educational material than would be necessary to fully review all of the content. Conclusions Simply providing educational material in a video with animations and voiceovers does not necessarily lead to better engagement from respondents or different preference outcomes in a sample of diabetes patients when compared to text. Increasing engagement with educational materials should be a topic of future research for those conducting patient preference research as no amount of educational material will be helpful if respondents do not access it. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-022-00612-9.

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Taking Patient Heterogeneity and Preferences Into Account in Health Technology Assessments

Abstract: Introduction: The INTEGRATE-HTA project provided methodology to evaluate complex technologies.

Cited by 24 publications

References 28 publications

Use of Patient Preference Information in Benefit–Risk Assessment, Health Technology Assessment, and Pricing and Reimbursement Decisions: A Systematic Literature Review of Attempts and Initiatives

Use of Patient Preference Information in Benefit–Risk Assessment, Health Technology Assessment, and Pricing and Reimbursement Decisions: A Systematic Literature Review of Attempts and Initiatives

Use of Patient Preferences in Health Technology Assessment: Perspectives of Canadian, Belgian and German HTA Representatives

The Impact of Video-Based Educational Materials with Voiceovers on Preferences for Glucose Monitoring Technology in Patients with Diabetes: A Randomised Study

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