Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T08:51:51.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Benchmarking health technology assessment agencies—methodological challenges and recommendations

Part of: Special Collection - Methods

Published online by Cambridge University Press:  08 September 2020

Ting Wang Open the ORCID record for Ting Wang [Opens in a new window] ,
Iga Lipska ,
Neil McAuslane ,
Lawrence Liberti ,
Anke Hövels  and
Hubert Leufkens
Ting Wang*
Affiliation:
Centre for Innovation in Regulatory Science, London, UK Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
Iga Lipska
Affiliation:
Centre for Innovation in Regulatory Science, London, UK Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
Neil McAuslane
Affiliation:
Centre for Innovation in Regulatory Science, London, UK
Lawrence Liberti
Affiliation:
Centre for Innovation in Regulatory Science, London, UK
Anke Hövels
Affiliation:
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
Hubert Leufkens
Affiliation:
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
*
Author for correspondence: Ting Wang, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

The objectives of the study were to establish a benchmarking tool to collect metrics to enable increased clarity regarding the differences and similarities across health technology assessment (HTA) agencies, to assess performance within and across HTA agencies, identify areas in the HTA processes in which time is spent and to enable ongoing performance improvement.

Methods

Common steps and milestones in the HTA process were identified for meaningful benchmarking among agencies. A benchmarking tool consisting of eighty-six questions providing information on HTA agency organizational aspects and information on individual new medicine review timelines and outcomes was developed with the input of HTA agencies and validated in a pilot study. Data on 109 HTA reviews from five HTA agencies were analyzed to demonstrate the utility of this tool.

Results

This study developed an HTA benchmarking methodology, comparative metrics showed considerable differences among the median timelines from assessment and appraisal to final HTA recommendation for the five agencies included in this analysis; these results were interpreted in conjunction with agency characteristics.

Conclusions

It is feasible to find consensus among HTA agencies regarding the common milestones of the review process to map jurisdiction-specific processes against agreed metrics. Data on characteristics of agencies such as their scope and remit enabled results to be interpreted in the appropriate local context. This benchmarking tool has promising potential utility to improve the transparency of the review process and to facilitate both quality assurance and performance improvement in HTA agencies.

Keywords

Health technology assessmentBenchmarking toolMedicines
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 4 , August 2020 , pp. 332 - 348
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Now with National Health Fund, Warsaw, Poland.

**

Now an independent researcher, Bilthoven, The Netherlands.

References

Sorenson, C, Drummond, M, Kanavos, P. Ensuring value for money in health care. The role of health technology assessment in European Union. Brussels, Belgium: European Observatory on Health Systems and Policies; 2008.Google Scholar
Drummond, M. Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care. 2002;24:244–58.10.1017/S0266462308080343CrossRefGoogle Scholar
Drummond, M, Neumann, P, Jönsson, B, Luce, B, JS, Schwartz, Siebert, U et al. Can we reliably benchmark health technology assessment organizations? Int J Technol Assess Health Care. 2012;28:159–65.CrossRefGoogle ScholarPubMed
European Commission. Impact assessment: Strengthening of the EU cooperation on Health Technology Assessment (HTA); 2018 Available from: https://ec.europa.eu/health/sites/health/files/technology_assessment/docs/2018_ia_final_en.pdf [Accessed 12 February 2018].Google Scholar
Kleijnen, S, Lipska, I, Leonardo Alves, T, Meijboom, K, Elsada, A, Vervölgyi, V et al. Relative effectiveness assessments of oncology medicines for pricing and reimbursement decisions in European countries. Ann Oncol. 2016;27:1768–75.CrossRefGoogle ScholarPubMed
Nicod, E, Kanavos, P. Commonalities and differences in HTA outcomes: A comparative analysis of five countries and implications for coverage decisions. Health Policy. 2012;108:167–77.CrossRefGoogle ScholarPubMed
Schelleman, H, Dupree, R, Kristensen, FB, Goettsch, W. Why we should have more collaboration on HTA in Europe: The example of sofosbuvir. J Pharm Policy Pract. 2015;8:13.CrossRefGoogle Scholar
Kristensen, FB, Gerhardus, A. Health technology assessments: What do differing conclusions tell us? Br Med J. 2010;341:c5236.CrossRefGoogle ScholarPubMed
Wilsdon, T, Fiz, E, Haderi, A, for Charles River Associates. A comparative analysis of the role and impact of health technology assessment: 2013 Final report; 2014. Available from: https://www.efpia.eu/media/25706/a-comparative-analysis-of-the-role-and-impact-of-health-technology-assessment-2013.pdf [Accessed 12 February 2018].Google Scholar
International Working Group for HTA Advancement, Neumann, PJ, Drummond, MF, Jönsson, B, Luce, BR, Schwartz, JS et al. Are key principles for improved health technology assessment supported and used by health technology assessment organizations? Int J Technol Assess Health Care. 2010;26:71–78.Google ScholarPubMed
Centre for Innovation in Regulatory Science (CIRS). Regulatory and Reimbursement Atlas, 2018. Available from: http://www.cirs-atlas.org/ [Accessed 12 February 2018].Google Scholar
Hirako, M, McAuslane, N, Salek, S, Anderson, C, Walker, S. A comparison of the drug review process at five international regulatory agencies. Drug Info J. 2007;41:291–308.10.1177/009286150704100302CrossRefGoogle Scholar
Rosenberg-Yunger, ZR, Thorsteinsdóttir, H, Daar, AS, Martin, DK. Stakeholder involvement in expensive drug recommendation decisions: An international perspective. Health Policy. 2012;105:226–35.CrossRefGoogle Scholar
Cai, J, McAuslane, N, Liberti, L. R&D briefing 69: Review of HTA outcomes and timelines in Australia, Canada and Europe 2014–2017. London, UK: Centre for Innovation in Regulatory Science; 2018.Google Scholar
Velasco, M, Perleth, M, Drummond, M, Gürtner, F, Jørgensen, T, Jovell, A et al. Best practice in undertaking and reporting health technology assessments. Working group 4 report. Int J Technol Assess Health Care. 2002;18:361–422.Google ScholarPubMed
Goodman, C. Toward international good practices in health technology assessment. Int J Technol Assess Health Care. 2012;28:169–70.CrossRefGoogle ScholarPubMed
Kristensen, FB, Lampe, K, Chase, DL, SH, Lee-Robin, Wild, C, Moharra, M et al. Practical tools and methods for health technology assessment in Europe: Structures, methodologies, and tools developed by the European Network for Health Technology Assessment, EUnetHTA. Int J Technol Assess Health Care. 2009;25:1–8.CrossRefGoogle ScholarPubMed
Lampe, K, Mäkelä, M, Garrido, MV, Anttila, H, Autti-Rämö, I, Hicks, NJ et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. Int J Technol Assess Health Care. 2009;25:9–20.CrossRefGoogle ScholarPubMed
Kleijnen, S, Pasternack, I, Van de Casteele, M, Rossi, B, Cangini, A, Di Bidino, R et al. Standardized reporting for rapid relative effectiveness assessments of pharmaceuticals. Int J Technol Assess Health Care. 2014;30:488–96.CrossRefGoogle Scholar
Kleijnen, S, George, E, Goulden, S, d'Andon, A, Vitré, P, Osińska, B et al. Relative effectiveness assessment of pharmaceuticals: Similarities and differences in 29 jurisdictions. Value Health. 2012;15:954–60.CrossRefGoogle ScholarPubMed
Kleijnen, S, Toenders, W, de Groot, F, Huic, M, George, E, Wieseler, B et al. European collaboration on relative effectiveness assessments: What is needed to be successful? Health Policy. 2015;119:569–76.CrossRefGoogle ScholarPubMed
Kristensen, FB, Husereau, D, Huic, M, Drummond, M. Identifying the need for good practices in health technology assessment: Summary of the ISPOR HTA Council Working Group report on good practices in HTA. Value Health. 2019;22:13–20.CrossRefGoogle Scholar
O'Neill, P, Devlin, NJ. An analysis of NICE's “restricted” (or “optimized”) decisions. Pharmacoeconomics. 2010;28:987.CrossRefGoogle ScholarPubMed
Lipska, I, Hovels, AM, McAuslane, N. The association between European Medicines Agency approval and health technology assessment recommendation. Value Health. 2013;16:A455–A455.CrossRefGoogle Scholar
Allen, N, Liberti, L, Walker, S, Salek, S. A comparison of reimbursement recommendations by European HTA agencies: Is there opportunity for further alignment? Front Pharmacol. 2017;8:834.CrossRefGoogle ScholarPubMed
Allen, N, Liberti, L, Walker, S, Salek, S. Health technology assessment (HTA) case studies: Factors influencing divergent HTA reimbursement recommendations in Australia, Canada, England, and Scotland. Value Health. 2017;20:320–28.10.1016/j.jval.2016.10.014CrossRefGoogle ScholarPubMed