PHP323 - ESTABLISHING AN ALIGNED VIEW OF MODERN, FORWARD-LOOKING HTA PROCESS

Abstract

To explore whether an aligned view of modern, forward-looking health technology assessment (HTA) process exists, or can be established. We conducted a literature review and interviews with 12 HTA experts from Europe, the US and Latin America. The literature review identified good principles for HTA. From the principles that were identified we distinguished between HTA good practice principles that are ‘universally’ accepted, and others where there is less consensus, or that pose implementation challenges. We formulated the latter group into six ‘future directions’ for modern HTA systems with alternative routes. We also reviewed how quality adjusted life year (QALY) based and therapeutic added value (TAV) approaches compare in meeting HTA good practice. The interviews were used to validate the six ‘future directions’ and discuss with leading opinion makers each of the alternative routes and /or different approaches to HTA. The six challenging ‘future directions’ for modern HTA systems were: outcomes used in HTA; the HTA lifecycle; handling uncertainty; the balance between flexibility and transparency; operationalisation of patient involvement; and transferability of HTA. All interviewees agreed that these are the most important topics for progressing a modern forward-looking HTA system. Flexibility in handling uncertainty was chosen most often as the most important of the ‘future directions’ for further work. All interviewees agreed that further research initiatives to explore these topics would be valuable. Interestingly, there was no consensus on whether use of a QALY-based or TAV-based approach is preferable, and it was suggested that it would be inappropriate to recommend one over the other for global use. One modern, forward-looking HTA is not feasible but good practice propositions should provide guidance with respect to each of the six ‘future directions’. Further research initiatives would be valuable to stimulate debate and provide clarity in these topic areas.