OP73 Tools That Can Aid Adaptive HTA To Ensure Rapid, Efficient, And Pragmatic Priority Setting: A Scoping Review

Abstract

Introduction

Producing new health technology assessments (HTA) can be a time-consuming process. With finite resources in HTA agencies, limited capacities in countries without formalized HTA processes, and growing interest for lifecycles approaches valuing health technologies; innovative and efficient HTA processes are needed. “Adaptive HTA”, referring to the pragmatic use of HTA methods and existing (HTA) evidence, might offer solutions. We will present the results from a scoping review that mapped existing tools, methods, practices to transfer existing HTAs; and reflect on these findings given our own experiences of adaptation processes in LMICs.

Methods

We undertook a scoping review and systematically searched five electronic databases. Inclusion of articles followed strict in- and exclusion criteria. Data extraction focused on information regarding tools, methods, and practices that could aid the transferability of HTA analysis. Here, HTAs referred to full-HTAs and other HTA products, as partial HTAs, economic evaluations, or systematic reviews. Lastly, we mapped the possible overarching factors that can affect transferability.

Results

The search (November 2020) identified 2030 hits, of which 19 were included. Most HTA transfers followed five steps that closely resemble a de novo HTA process. The identified transferability tools, often checklists, were merely aids or a “catalyst” for the transfer and provided limited guidance for the whole transfer process. Contrastingly, we identified three frameworks that can support the whole process: European Network for HTA (EUnetHTA) Adaptation Toolkit, TRANSFER framework for systematic reviews, and paper series on systematic reviews for economic evaluations. Lastly, our findings pointed to various challenges and knowledge gaps; especially for transfers in low and middle income countries evidence is limited.

Conclusions

The re-use of existing evidence in HTA reports is not new; and readily part of de novo and adaptive processes. The innovative nature of adaptive HTA comes from its ability to unpack the process of adaptation and transferability. Simultaneously, this scoping review highlighted gaps in existing adaptive methods, and could aid future adaptive HTA process for experienced and new HTA-doers.