Over the last ten years, Health Technology Assessment (HTA) has become an increasingly important part of the assessment system for new medicines. It is generally agreed that HTA has the potential to assist payers in making informed decisions about allocating resources (including expenditure on medicines) in the health system. However, it is also possible that a poorly designed or managed HTA process runs the risk of denying patients appropriate access to medical technologies, inefficiently allocating resources, constraining clinical freedom and sending distorted signals to medical technology providers.
To this end a considerable amount of effort has been put into developing best practice principles which demonstrate a degree of consensus between academia, payers and industry. Charles River Associates (“CRA”) was asked by EFPIA, PhRMA, Medicines Australia and EuropaBio to undertake a comparative assessment of the role and impact of Health Technology Assessment (HTA) in different parts of the world. In this report, we use these principles to compare how different systems use HTA, the basis of the approach they apply, how it works in practice and the consequences for the key stakeholders.
The objective of the project was to build upon, rather than replicate, the various published studies that have compared HTA systems in order to develop the lessons that can be drawn from different national models in the world. Hence, the project started with a literature review of existing frameworks for comparison, the use of HTA focusing on its role and impact (rather than the merits of particular methodologies). Following this we agreed a set of countries to be included in the assessment including countries which use HTA in different ways and countries with long-established systems as well as markets where HTA is still under development.