PNS163 The Definition of Innovation in Health Technology Assessments (HTA): A Systematic Literature Review

Abstract

A major goal of current pharmaceutical pricing and reimbursement policies is to maintain affordability and access to medicines, yet at the same time provide incentives for continued innovation. While the term “innovation” is widely used, it often remains undefined or is defined differently depending upon the perspective. Accordingly, establishing a link between the level of innovativeness and price premiums poses a major challenge. In this study, we systematically review current literature and discuss how pharmaceutical innovation is defined in health technology assessments (HTA) of different countries and how it is incentivized and rewarded through pricing and reimbursement schemes. We conducted a systematic literature review using PubMed and the Social Science Citation Index (SSCI) and covering articles published from 2010 to 2019. Our review shows that innovation beyond the added therapeutic value is rarely considered in HTAs. While other elements such as nature of treatment or ease and convenience of administering the drug are occasionally considered, only the added therapeutic value is crucial when it comes to pricing and reimbursement decisions. Regarding changes to the current approaches, our review shows that most studies do not advocate drastic changes to the current methods of capturing innovation in pricing policies. Suggestions focus on how added therapeutic benefits, given they exist, are considered in HTAs rather than how innovation should be defined in the first place. Innovation is a widely but variously used term. Generally, a drug that is considered innovative implies that it has properties that are worthy of recognition and reward and that the product has a unique value. However, notions of value are a matter of perspective and valuing innovation is a complex and difficult task. Since the value of innovation could be derived from more unobvious benefits, changes in the current assessment process may be warranted.