Systematic Review of Tools and Approaches for Evaluating the Transferability of Health Technology Assessments Across Different Jurisdictions

Abstract

Background: This study aims to review tools that have been developed for the transferability of Health Technology Assessment (HTA) information to different countries. HTA is increasingly being used as a tool in health policy decision-making, but its complexity and lack of local expertise have limited its usage in many countries. The World Health Organization has taken measures to encourage countries to conduct and use HTA, including through resolutions from the Eastern Mediterranean (EM) Regional Committee in 2019. However, due to limitations in national technical capacities, there is a need to adapt HTA information from other settings to fit the specific context of each country. Therefore, this study aims to systematically review the tools that have been developed for HTA transferability and assess their strengths and limitations. Methods: The systematic review included studies that introduced tools, methods, and frameworks for transferability of HTA information across jurisdictions. Databases such as MEDLINE, EMBASE, Cochrane Library, Epistemonikos, Web of Sciences, health economic database, Scopus, and Google-Scholar were searched, along with relevant bibliographies. The data was extracted and synthesized using both tabulation and narrative approaches. The evaluation of the tools involved assessing various criteria, such as user-friendliness, efficiency in screening, and considerations regarding transferability factors. Results: A total of 10,375 documents were evaluated, resulting in 17 studies that met the inclusion criteria. These 17 studies consisted of 13 newly developed tools/methods that were appraised. The majority of the models were checklists, with only a few deemed suitable for full HTA. Three models have been validated through published studies, but there is no evidence of utilization in the countries of the EM region. Conclusion: While the existing tools provide valuable resources for evaluating transferability, there remains a need for a more comprehensive tool to support decision-makers in low-resource settings considering country context and capacity.