The ‘Top 10’ Challenges for Health Technology Assessment: INAHTA Viewpoint

O’Rourke, Brian; Werkö, Sophie; Merlin, Tracy; Huang, Li; Schuller, Tara

doi:10.1017/s0266462319000825

Cited by 42 publications

(37 citation statements)

References 6 publications

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“…This might also explain-at least partly-the barriers for reaching a decision about a PH technology or the implementation of a PH intervention as mentioned by the respondents of our survey. Similar elements are reported in the recently published INAHTA viewpoint (44).…”

Section: Discussionsupporting

confidence: 89%

Evaluating Public Health Interventions: A Neglected Area in Health Technology Assessment

Stojanovic

Wübbeler

Geis

et al. 2020

Front. Public Health

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Introduction: Public health (PH) interventions are crucial for ensuring sustainable healthcare services. Nevertheless, they represent a neglected area in the field of health technology assessment (HTA) due to various methodological issues and their complex design that goes beyond clinical setting. The present study provides an environmental scan of HTA initiatives related to the assessment of PH technologies on a global level.Methods: We conducted a cross-sectional survey among 85 HTA-related European and international societies, health bodies, and networks from September 2018 to January 2019. The questionnaire contained four sections and 18 questions regarding activities related to the evaluation of PH technologies, information on existing PH technologies, and methodologies of assessment as well as barriers and facilitators to reaching a decision and implementing a PH technology.Results: Among 52 survey responses, the majority of the respondents came from European countries (35%), followed by North American (27%), and South American (19%) countries. The main type of organizations covered by our survey included HTA agencies, public administrations, and research institutes. Seventy-one % of the institutions reported engagement in any aspect of HTA in the area of PH (N = 37). Among those, 81% evaluated less than 5 PH technologies from 2013 to 2018. The most common barriers for reaching a decision on PH technologies were lack of data, conflicting stakeholder priorities, and methodological issues. A total of 76 PH interventions were reported, and most cited initiatives were related to chronic disease screening, prevention of infectious diseases, and maternal, prenatal, and neonatal screening.Conclusion: Our survey reported a rather limited involvement of HTA in the evaluation of PH technologies. In particular, an evaluation of behavioral and lifestyle interventions remains extremely rare. The implementation of collaborative HTA approaches in the setting of PH practice and policy needs to be prioritized and further strengthened. Moreover, ensuring reliable data structures and consolidation of HTA methods for the evaluation of PH technologies will be crucial for tackling the enormous burden of non-communicable diseases in societies.

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Section: Discussionsupporting

confidence: 89%

Evaluating Public Health Interventions: A Neglected Area in Health Technology Assessment

Stojanovic

Wübbeler

Geis

et al. 2020

Front. Public Health

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“…Our findings indicate that there are only a limited number of robust and complete HTA reports for biosimilars, mainly due to the absence of a systematic literature review, failures in the appraisal of the quality of the evidence, and a lack of consideration of economic issues such as budget impact and cost-effectiveness. A summary of the top 10 challenges to produce an HTA identified by INAHTA members pointed out that the increasing demand for HTAs was often accompanied by a request for greater speed, leading to an increased demand for rapid HTA [17]. Additionally, INAHTA members considered that the use of an evidence grading system when formulating recommendations was a challenge [17].…”

Section: Discussionmentioning

confidence: 99%

“…A summary of the top 10 challenges to produce an HTA identified by INAHTA members pointed out that the increasing demand for HTAs was often accompanied by a request for greater speed, leading to an increased demand for rapid HTA [17]. Additionally, INAHTA members considered that the use of an evidence grading system when formulating recommendations was a challenge [17]. This is reflected in the findings of this scoping review, since the majority of reports did not adequately appraise the quality of evidence with an appropriate approach or tools [38] such as the GRADE system for assessment of overall quality of evidence or tools to assess the methodological quality of primary studies such as the Assessing the Methodological Quality of Systematic Review (AMSTAR) and the Cochrane Risk of Bias tools.…”

Section: Discussionmentioning

confidence: 99%

“…The vital contribution of Health Technology Assessment (HTA) for informed decision-making and the creation of equitable, high-quality and sustainable healthcare systems is well recognised and consolidated in scientific and technological practice [17]; however, there is still no generally accepted position on its utilisation in relation to biosimilars [18]. In fact, the evidence needed to obtain marketing authorisation from a registration authority does not always correspond to the data requirements for an HTA [9,18].…”

Section: Introductionmentioning

confidence: 99%

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Health technology assessment of biosimilars worldwide: a scoping review

Ascef

Lopes

Soárez

2020

Health Res Policy Sys

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Background: Health technology assessment (HTA) should provide an assessment of a technology's effects on health and of the related social, economic, organisational and ethical issues. HTA reports on biosimilars can specifically assess their immunogenicity, their extrapolation to one or more conditions, and the risks of interchangeability and substitution. We aimed to complete a scoping review within the context of HTA organisations to synthesise HTA reports on biosimilars and to map the extension, scope and methodological practices. Main body: A scoping review methodology was applied. The sources for biosimilars HTA reports were database searches and grey literature from HTA organisation websites up to June 2019. HTA reports of biosimilars were classified as full HTA, mini-HTA or rapid reviews. Data were extracted and recorded on a calibrated predefined data form. We identified 70 HTA reports of biosimilars of 16 biologic products (65.71% in 2015-2018) produced by 13 HTA organisations from 10 countries; 2 full HTAs, 4 mini-HTAs and 64 rapid reviews met the inclusion criteria. Almost all the rapid reviews gave no information regarding any evidence synthesis method and approximately half of the rapid reviews did not appraise the risk of bias of primary studies or the overall quality of evidence. All full-HTAs and mini-HTAs addressed organisational, ethical, social and legal considerations, while these factors were assessed in less than half of the rapid reviews. The immunogenicity and extrapolation of one or more conditions were often considered. The majority of full-HTAs and mini-HTAs contained an assessment of switching and a discussion of an educational approach about biosimilars. No HTA report rejected the adoption/reimbursement of the biosimilar assessed. Conclusion: HTA of biosimilars are emerging in the context of HTA organisations and those that exist often duplicate reports of the same biosimilar. Most HTA reports of biosimilars do not conduct a systematic literature review or consider economic issues. No report has rejected the adoption/reimbursement of biosimilars. There is a need to standardise the minimum criteria for the development of HTA on biosimilars to ensure a better understanding and better decision-making.

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“…HTA bodies require information and expertise from a range of stakeholders to develop guidance (8). One key challenge is designing meaningful approaches to involving stakeholders and patients (9), ensuring that PPI is not tokenistic but adds value. Effective PPI approaches cannot be developed by HTA bodies in isolation; instead, they should be coproduced with stakeholders.…”

Section: Introductionmentioning

confidence: 99%

Strengthening patient outcome evidence in health technology assessment: a coproduction approach

Rasburn

Livingstone

Scott

2021

Int J Technol Assess Health Care

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The National Institute for Health and Care Excellence (NICE) worked with patients and staff from six patient organizations to review existing health technology assessment (HTA) methods and coproduce proposals to improve the following: patient involvement, how patient evidence is identified and considered by committees, and the support offered to patient stakeholders. This engagement identified important factors that HTA bodies need to understand to enable meaningful patient and public involvement (PPI), such as having clearly documented processes, appropriate evidence submission processes, transparent decisions, and suitable support. This work demonstrated the benefits of HTA bodies working collaboratively with patient stakeholders to improve PPI. By doing so, HTA bodies can increase their knowledge and understanding of the barriers faced by patient stakeholders to develop appropriate solutions to remove them. The coproduction approach improved stakeholder engagement methods, provided a better analysis of data, supported the development of meaningful conclusions, and improved stakeholder relationships.

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The ‘Top 10’ Challenges for Health Technology Assessment: INAHTA Viewpoint

Cited by 42 publications

References 6 publications

Evaluating Public Health Interventions: A Neglected Area in Health Technology Assessment

Evaluating Public Health Interventions: A Neglected Area in Health Technology Assessment

Health technology assessment of biosimilars worldwide: a scoping review

Strengthening patient outcome evidence in health technology assessment: a coproduction approach

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