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Blog
Testing Times for Health Technology Assessment (HTA)
Eoin Jennings, Manager, IQVIA Pharma Pricing & Reimbursement
Aug 31, 2020
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With the ongoing coronavirus pandemic continuing to upend healthcare systems and economies around the world, health technology assessment (HTA) agencies have found themselves (unsurprisingly) in a difficult position. With healthcare priorities in many countries shifting towards the search for treatments that can help alleviate the effects of COVID-19, the disease caused by the coronavirus, many HTA organisations are facing difficult decisions on how best to allocate their scarce resources. Using IQVIA’s Pharma Pricing & Reimbursement service, this blog assesses the changing HTA landscape around the world.

Many HTA organisations face pressures on multiple fronts. Quite apart from the difficulties imposed by stringent ‘lockdown’ measures in many countries, designed to reduce the movement of citizens and so curb the virus’ spread, HTA agencies must deal with the fact that governments’ short-term healthcare priorities have changed. HTA bodies typically rely on the input of clinical experts when formulating their recommendations in relation to new medical technologies (including prescription drugs), but with health systems under unprecedented pressure, such experienced medical professionals are prioritising ‘front line’ medical care.

Thus, for example, the National Institute for Health and Care Excellence (NICE) in the UK (which produces guidance for healthcare providers in England, Wales and Northern Ireland) has advised that timelines for many of its ongoing drug appraisals are to be reviewed. Meanwhile, the Scottish Medicines Consortium (SMC) decided in spring to cancel all committee meetings that were to have taken place in the period April through June 2020 so that its members and staff could focus on front line care. The agency tentatively resumed technology appraisals in July 2020, but has continued to adopt a selective approach in terms of which technologies it prioritises for assessment, given the backlog that has built up. Similarly, the All Wales Medicines Strategy Group (AWMSG), which provides guidance on medicines not (yet) evaluated by NICE, decided to suspend its “normal business” through the end of May 2020 as a result of the pandemic.

Such disruption can be seen elsewhere, too. In Germany, the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) has extended the comment and feedback periods for a number of ongoing assessments, although the agency is maintaining a full programme of evaluations. Denmark’s Medicines Council (Medicinrådet) has also warned of delays in its evaluations, though it is unable to predict when or where these may occur.

Not all HTA agencies are impacted in the same way, of course – reflecting not only the varying burden of COVID-19 in different countries, but also perhaps fundamental differences in the way in which HTAs are conducted, and the level of health system resource required. Ireland’s National Centre for Pharmacoeconomics (NCPE) and Portugal’s National Authority of Medicines and Health Products (Autoridade Nacional do Medicamento e Produtos de Saúde, INFARMED), for example, appear able to proceed with “business as usual” for now.

And despite the disruption, HTA bodies are turning their attention to providing advice to governments and health systems on tackling the virus itself. NICE has for example stated it is now prioritising the development of guidance in relation to the diagnosis and treatment of COVID-19 including the publication of new “rapid guidelines” developed expressly for this purpose. INFARMED and Poland’s Agency for Health Technology Assessment and the Tariff System (Agencja Oceny Technologii Medycznych i Taryfikacji, AOTMiT) have similarly produced a range of COVID-19 related guidance for healthcare providers.

HTA agencies in some countries could also be primed to take a more prominent role in public discussion of the virus. Indeed, in many ways HTA organisations are uniquely placed to deliver evidence-based information about how members of the general public should respond to the threat posed by COVID-19.

It has been widely observed that the speed of the virus’ spread around the world has been matched only by the deluge of misinformation that has accompanied it, a phenomenon that has been amplified by the ease with which such distortions can be shared via social media platforms such as Facebook and WhatsApp. It is significant, therefore, that the Canadian Agency for Drugs and Technologies in Health (CADTH) has devoted significant resources to developing a COVID-19 portal containing information only from “trusted sources” and aimed at a general audience, including advice on whether users should trust “Dr Google”. Evidence, perhaps, of how the coronavirus crisis may already be subtly shifting the HTA landscape.

IQVIA Pharma Pricing & Reimbursement (PPR) draws on decades of experience in the market access space to bring you the latest global developments in pricing and reimbursement. With access to IQVIA’s network of local offices, and extensive contacts within government and industry, the PPR service offers timely news and articles alongside comprehensive guides to P&R regulations around the world.

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