What kind of HTA does the US need?

Should the US have a formal, centralized health technology assessment (HTA) organization? In the United Kingdom, the National Institute for Health and Care Excellence (NICE) plays this roles and has a significant impact on drug pricing in the UK. However, the UK relies on a single payer system and NICE’s recommendations can be directly implemented…

HTA criteria used to evaluate diagnostics

When evaluating a new diagnostic, HTA agencies must assess two separate issues: analytical and clinical validity. Analytical validity basically indicates whether the test works; is it able to accurately predicts the presence or absence of a particular biomarker of interest. Clinical validity is whether the test matters in clinical practice.  It could be the case…

ICER vs. NICE

A nice (pun intended) paper by Thokala et al. (2020) compares the Institute for Clinical and Economic Review (ICER) with the National Institute for Health and Care Excellence (NICE) along 4 dimensions: structure, methods, process, and use in decision-making. While ICER and NICE methods are fairly similar, ICER is a non-governmental body without any explicit…

What do HTA decisionmakers care about?

Is it clinical benefit? Cost? Value? The availability of treatment alternatives? To answer this question, a paper by Wranik et al. (2019) conducted a discrete choice experiment DCE to determine HTA stakeholders stated preferences. The sample consisted of HTA stakeholders from 5 countries: Australia, Canada, Germany, Poland, and the United Kingdom. The stakeholders included not…

How should we define “unmet need”?

Many health technology assessment (HTA) agencies give additional consideration to treatments if there is unmet need. But what really defines unmet need?  According to an article by Vreman et al. (2019), there are three key elements.  First, there should be no or limited treatment alternatives.  If there are lots of good treatment options available, then…

How do payers use patient reported outcomes?

This is the question asked by a study conducted by Brogen et al. (2017).  To see how payers use patient reported outcomes (PRO) in oncology, the authors conducted a literatures search, and searched the websites of the following health technology assessment bodies: Pharmaceutical Benefits Advisory Committee (PBAC) in Australia, Canadian Agency for Drugs and Technologies…

Adding the patient perspective to health technology assessment

Health technology assessments (HTAs) aim to measure the cost effectiveness of a given treatment or set of treatments for a specific patient populations.  Often, these assessments are conducted from the point of view of the payer–either a national health system or the individual insurer perspective.  This payer focused perspective can often focus largely on treatment costs rather…