bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP02 The Use Of Discrete Choice Experiments For Measuring Patient Preferences In Health Technology Assessment
Authors: Strauss Michael , George Gavin , Hirsch-Moverman Yael , Mantell Joanne , Rabkin Miriam , Kelvin Elizabeth 
Published: December 2022

IntroductionUnderstanding patient preferences and the demand for healthcare interventions and technology is critical for health technology assessment (HTA). New health technologies have potential for savings and increased efficiency but even the most cost-effective and efficacious interventions can fail if patient preferences are not properly accounted for. Patient preferences in HTA are primarily limited to representation in appraisal committees; however, more robust methods are available and should be incorporated into the assessment of interventions.MethodsUsing data from three discrete choice experiments (DCEs), we reflect on the importance of patient preferences in the design of healthcare interventions. We draw insights from three studies which investigated preferences relating to HIV self-testing amongst long distance truck drivers in Kenya; differentiated antiretroviral therapy services amongst stable HIV patients in Zimbabwe; and tuberculosis preventive therapy for children in Eswatini.ResultsWe highlight three key findings. First, understanding patient preferences is crucial when designing services, and providers sometimes underestimate behavioural barriers and overestimate the extent to which people are motivated simply by health benefits. Optimism is often driven by evidence showing high acceptability, but when preference structures are incorporated in intervention design, there are important insights into how patients plan to utilize services. Second, trade-offs matter in determining which characteristics are perceived to be most important to patients – a key strength of the DCE methodology. Understanding of these trade-offs can help prioritize which characteristics of interventions to target. Finally, disentangling the effect of different characteristics of service delivery models on preferences is important for rethinking how interventions are delivered. If services are designed to better align with preferences, implementers can ensure new interventions have the desired effect on health and economic outcomes.ConclusionsThese findings highlight the value of behavioural economic approaches for investigating preferences for health interventions and providing insights into the demand for services, which must feed into the HTA analyses. Incorporating DCEs into HTA is inexpensive and provides robust data for improving HTA.
OP13 EUnetHTA Relative Effectiveness Assessments Of Pharmaceutical And Other Technologies: Procedural Changes Implemented During Joint Action 3
Authors: Ettinger Sabine , Willemsen Anne , Erdos Judit , Helmink Catharina , Hviding Krystyna , Ormstad Sari Susanna 
Published: December 2022

IntroductionThe European Network for Health Technology Assessment (EUnetHTA) Joint Action 3 (JA3) aimed to develop a sustainable European model for scientific and technical collaboration on HTA. It succeeded EUnetHTA JA2, which focused on strengthening practical applications of approaches and tools in the European HTA collaboration. Compared to JA2, several changes in procedures and processes were undertaken throughout JA3 in order to improve the different steps in joint HTA production.MethodsFindings and identified challenges regarding the assessment production processes from JA2 were considered as a basis. In JA3, vast majority of structured and informal feedback was gathered from the assessment teams and project managers via feedback surveys and meetings. Only limited informal feedback from stakeholders (such as patients, health care professionals, and health technology developers) that were involved in EUnetHTA assessments was collected. To this end, experiences were documented and recommendations for a future production process were developed.ResultsDuring the course of JA3, the joint production resulted in 16 pharmaceutical assessments and 27 assessments of other technologies. The latter included medical devices, diagnostics, interventions, and screening. Due to the different context of pharmaceuticals and other technologies, some technology-specific changes needed to be made in their production process. However, the majority of implemented changes were made for both types of technologies to ensure maximum possible alignment in processes. The implemented changes affected several steps in the production process as well as the involvement of stakeholders in EUnetHTA assessments. The production and related project management of assessments was fine-tuned and resulted in clearer, standardized, and comprehensible processes that facilitated transparency and inclusiveness.ConclusionsThe procedural changes led to further standardization and elaboration of assessment production processes in preparation for a future European HTA system under the EU HTA Regulation. However, some methodological challenges remained to be tackled further in the currently ongoing EUnetHTA 21 service contract.
OP24 Impact Of Patient Input On Cancer Drug Funding Recommendations In Canada
Authors: Wranik Wiesława Dominika , Vo Anh Thu , Hu Min 
Published: December 2022

IntroductionPatient involvement in health technology assessment (HTA) has documented advantages, such as improved understanding of disease context, and increased legitimacy and transparency of the HTA process. In the absence of clear metrics, thresholds, or criteria, it is not clear how input regarding patient preferences influences HTA based recommendations of the pan Canadian Oncology Drug Review (pCODR).MethodsThis is a concurrent complementary mixed methods study. A quantitative model (logit) is used to estimate the impact of patient input and other HTA criteria on pCODR recommendations. A qualitative analysis of semi-structured interviews with Canadian HTA committee members is used to describe the mechanisms of action through which patient input influences recommendations.ResultsPatient input was considered important in providing context to the HTA discussion, but committee members were not able to explicate how any specific elements of patient submissions weighted into the committee’s recommendation. There was an element of mistrust in the patient input data. The estimated impact of patient input on funding recommendations is not statistically significant, recommendations remain driven by evidence of clinical benefit.ConclusionsThe commitment to inclusion of patient perspectives in HTA in Canada is strong, and procedurally Canada is among the leaders in this regard. The tangible impact of patient input could be increased with an improved system for collection of most relevant data, and clear guidelines about how patient input should weigh into HTA recommendations.
OP26 Policy Perspectives Of Health Technology Assessment In Ethiopia
Authors: Ararso Desalegn 
Published: December 2022

IntroductionHealth technology assessment (HTA) is defined as a multidisciplinary field of policy research that provides evidence on the consequences of adopting and using health technologies. A ministry of health with jurisdiction over HTA should determine the influence of public law on all HTA-related activities and the rules that apply. Therefore, health decision-makers interested in HTA must learn to navigate the legal system, starting by situating it in the legal apparatus of the country. As a result, establishing a national HTA system requires designing a legal pathway towards HTA. However, a historic overview of HTA, in the context of policy documents of Ethiopia is not clearly reported. Therefore, this review is warranted to understand the historic overview of HTA in the context of health policy documents of Ethiopia.MethodsA review of online policy documents was conducted in advanced Google Scholars and websites of the Ministry of Health (MoH) of Ethiopia. Some of the policy documents were also obtained through contacting experts at MoH. The review findings were organized into six categories.ResultsRegulatory documents have emphasized the approval of new health technologies before selecting health technologies. Health Policy of Ethiopia and the Directive on Medical Equipment also clearly stated the importance of institutionalizing HTA and establishing HTA organizations. Additionally, the National Medical Device Policy clearly indicated the importance of establishing an HTA advisory team at MoH. Similarly, the Health Sector Transformation Plan II (HSTP II) stressed the need to build a national capacity to conduct HTA. Even though policy statements on HTA appear scattered across different policy documents, they were not put into a national HTA system.ConclusionsIt is important to refer to policy statements outlined in different policy documents when establishing a national HTA system in Ethiopia. Also, attention should be given to the development of policy documents related to HTA guidelines, strategic documents in HTA, and policy documents that can link HTA results to policy-making.
OP27 Health Technology Assessment Processes, Characteristics, And Key Differences In High, Middle, And Low-Income Countries Of Asia Pacific Region
Authors: Verma Ashish 
Published: December 2022

IntroductionThe healthcare sector in the Asia Pacific (APAC) region is in a period of rapid growth and exciting innovation. This has led to an increase in the number of APAC countries adopting and implementing health technology assessment (HTA) to assess the clinical, ethical, economic, and societal aspect of healthcare technology. The aim of this study is to provide an updated snapshot of the status of HTA and key differences in selected countries of APAC region.MethodsHTA robustness and gap requirements, including its structure, process, use in decision-making and resource allocation processes were assessed through a review of published and gray literature for each of the selected country. A qualitative analysis was carried out by using a set of 15 principles of an International Working Group for HTA Advancement to identify the robustness and key differences in HTA based decision-making process in scoping countries.ResultsThe finding of this study reveals that maturity of HTA determined by country-specific factors, such as presence of independent HTA agency, healthcare funding and expenditure, etcetera, and varies across the high-, middle-, and low-income countries of APAC region. Based on the study’s results, HTA ecosystem of selected countries categorized into rising HTA followed by advancing and mature HTA categories. In addition to the differences in HTA structure, the influence of stakeholder engagement differs among HTA bodies. The variation in the time frame of HTA decisions was significant among countries, with a general lack of awareness and transparency among health policy decision-makers and resulted in longer time for assessment for rising HTA category compared to the advance and mature HTA categories.ConclusionsThe vision of a comprehensive and robust HTA system can be achieved by implementing a transparent, independent, decision-making, and strongly integrated HTA process in the region. We recommend that efforts should be directed to promote a transparent and sustainable HTA, throughout the low- and middle-income countries of APAC region which eventually, lead to more effective HTA ecosystem.
OP34 Horizon Scanning A Matter Of Collaboration. A Description Of The Processes Of I-HTS Member Organizations
Authors: Gutierrez-Ibarluzea Iñaki , Otte Maximiliam , Dauben Hans-Peter , Blasco-Amaro Juan Antonio , Mohamed Ghazali Izzuna-Mudla , Bt Akmal Syaqirah , Gomes Pollyanna , Huang Grace , Kearney Brendon 
Published: December 2022

IntroductionHorizon Scanning (HS) has been part of the health technology assessment (HTA) world since the end of 20th century. In accordance with the life cycle concept of heath technologies, there have been different organizations that have devoted part of their portfolio to HS’s so called Early Awareness and Alert Systems. In 2017, a legal entity international Health Tech Scan (iHTS) was created on the basis of the previous existing network EuroScan. Our aim is to describe the current achievements of the network, the methods used by its members, and their achievements.MethodsIn 2010, EuroScan decided to analyze its members’ methods and processes to perform HS. We used a previously defined questionnaire to revisit the analysis of methods, processes, and impact of the founded legal entity i-HTS. We analyzed the clients, stakeholders involved, impact on health systems and alliances, as well as the current achievements as a group.Resultsi-HTS is currently rooted mainly in Europe and Asia-Pacific with members in the Americas and with ambassador programmes in Africa. The individual members have continued their achievements with special focus on three main aspects: proactive approach to innovators, stakeholder involvement, and client orientation. In most cases, the members of i-HTS produce information that is used for decision-making purposes, some of which influences the national or regional benefit package. Methods did not differ but the level of involvement of stakeholders in the different phases of the process. Some members also include in their portfolio early advice to innovators.ConclusionsEarly Awareness and Alert Systems are key to inform health care systems around technologies that could impact the management of patients in different contexts. There is a need to better understand the needs of the clients and the importance of HS in order to improve their efficiency. iHTS is in the process of redesigning its methods toolkit with the participation of all its members.
OP44 Does The Health Economic Modelling Structure Matter? An External Validation Of Three Approaches Commonly Used In Obesity Modelling
Authors: Schwander Bjoern , Kaier Klaus , Hiligsmann Mickaël , Evers Silvia , Nuijten Mark 
Published: December 2022

IntroductionObesity, defined as a body mass index (BMI) greater than 30kg/m2, is a multifactorial disease with severe health and economic consequences. As obesity associated events impact long-term survival, health economic (HE) modelling is commonly used. However, the current set of modelling approaches are very diverse and lack external model validation. The aim of our research was to compare the event simulation and the HE outcomes of different structural approaches.MethodsWe performed an external validation of three main structural modelling approaches for estimating obesity-associated events: (i) continuous BMI-related risks; (ii) general risk equations; and (iii) categorical BMI-related risks. The Swedish Obese Subjects (SOS) intervention study was used for validation. Outcomes compared were mortality, cardiovascular events (CVE), and type 2 diabetes (T2D), over time using the long-term data from the SOS study, looking at both the surgery arm and the control arm. Concordance between modelling results and the external validation study was measured by visual examination of the best fitting linear regression lines, R2 coefficients, the root mean squared errors, and F-tests. Furthermore, we compared the HE modelling results, comparing surgery versus control, expressed as cost per quality-adjusted life-year (QALY) gained based on 1,000 Monte Carlo simulation samples.ResultsMortality was overestimated by all approaches irrespective of the study arm. For CVE an overestimation by all structural approaches was observed for the control arm. The CVE surgery arm was overestimated by the categorical BMI approach and slightly underestimated by the others. For T2D an underestimation was observed for the continuous and the categorial BMI approaches, whereas there was an overestimation by the risk equation approach. Considering different confidence interval limits, the cost per QALY gained are comparable between all structural approaches.ConclusionsNone of the structural approaches provided perfect external event validation results although the risk equation approach showed the smallest deviations compared to the external validation study. The cost per QALY gained resulting from the three approaches were fairly comparable.
OP54 The Early Detection And Warning System ‘SINTESIS-New Technologies’: A Horizon Scanning Experience In Spain
Authors: Hijas-Gómez Ana Isabel , Luengo-Matos Setefilla , Arias-Pacheco Amparo , Rodriguez-Ortiz-de-Salazar Begoña , Sánchez-Gómez Luis Maria , del Mar Polo-de-Santos Maria 
Published: December 2022

IntroductionSINTESIS-new technologies is the early warning system for new and emerging technologies of the Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III. SINTESIS is part of the Action Plan for the Early Detection of New and Emerging Technologies of the Spanish Network of Health Technology Assessment Agencies (RedETS). In RedETS, four agencies are responsible for the identification of innovative technologies. These agencies have been collaborating since 2016 according to the early awareness methods contained in the EuroScan Methods Toolkit. SINTESIS focuses on secondary information sources (i.e., experts and literature). This study describes the experience of SINTESIS in identifying and filtering new technologies in recent years.MethodsRetrospective analysis of all new and emerging technologies notified by SINTESIS to RedETS since 2018. Technologies were analyzed on a year-by-year basis for their source of information, the clinical specialties involved, and whether technologies found in the identification phase were selected for further assessment.ResultsBetween 2018–2020, SINTESIS identified 69 emerging and new technologies. Most of the information came from medical press news (35%), and medical web news (22%); other sources included experts (15%), licensing news search (12%), general press (12%), and scientific websites (6%). Almost 37 technologies (54%) were selected for further analysis. Reasons for exclusion included too early identification of technologies/prototypes without enough evidence (52%), technologies already implemented (28%), overlapping technologies between agencies (17%), and not being medical technologies (3%).ConclusionsExperience suggests that news sections of general and medical journals, websites, and expert consultation are useful sources to identify new and emerging health technologies. The main limitation is that the technologies identified are often at too early a stage of development for further assessment. SINTESIS contributes, within a national horizon scanning system with other agencies, to broaden the information sources and provide useful data on early awareness of innovative technologies. Further studies are needed to assess the impact of emerging technologies detection on healthcare delivery.
OP55 Classification System For Innovative Medicines In The Pipeline: New Or Repurposed?
Authors: Ogunbayo Dapo , Coughlan Diarmuid , Fairbairn Ross , Akinbolade Sola 
Published: December 2022

IntroductionWhile various criteria exist to define or categorize innovative medicines as new or repurposed, to our knowledge there are no standardized systems that sufficiently capture the range of pipeline products. The National Institute for Health and Care Research Innovation Observatory (NIHR IO) undertakes routine horizon scanning to support health technology assessment (HTA) in England and maintains a comprehensive Medicines Innovation Database (MInD). The aim of this project is to develop a ‘technology type’ (new versus repurposed) classification system for application within the MInD and to provide a high-level analysis of the emergent data.MethodsWe reviewed gray literature, regulatory websites, and drug repositories to identify existing ‘technology type’ classification criteria. Preliminary definitions and classifications for use on the MInD were discussed, refined, and agreed by consensus. Innovative medicines on the MInD were classified as either new or repurposed based on their regulatory approval status (Marketing Authorization) using data from the electronic medicines compendium. For repurposed medicines, further classification was undertaken using abbreviated new drug application (ANDA) data from the FDA Orange Book to identify generic medicines (patency and exclusivity status). We combined a range of semi-automated and manually derived data during this process.ResultsSix technology types were identified and applied to the MInD: (i) new technology; (ii) repurposed technology (on-patent/branded); (iii) repurposed drug (off-patent/generic); (iv) repurposed technology (never commercialized); (v) new and repurposed technology (combinations); and (vi) repurposed technology (combinations). Preliminary analysis of a subset of MInD records identified in July 2021 (n = 113) found mainly 52 percent new technologies, 27 percent new and repurposed technologies (combinations) and 14 percent repurposed technology (never commercialized). Further analysis of approximately 7000 MInD records are ongoing and will report temporal trends, regulatory status, and key challenges.ConclusionsOur novel evidence-based approach to developing classifications for technology types of innovative medicines resulted in six mutually exclusive states that can be applied to a larger dataset. We believe this offers HTA stakeholders a mechanism to gain valuable insights into the innovation trends, gaps, and areas of unmet need.
OP60 Methodological Guidance And Doctrine Of The French National Authority For Health For Economic Evaluation
Authors: Raimond Véronique ,   Commission for Economic and Public Health Evaluation
Published: December 2022

IntroductionThe French National Authority for Health (HAS) “defines and issues guidelines and medico-economic opinions on prevention, healthcare, prescription, and best care strategies, and contributes to their comparison or ranking to support public health and optimize health insurance spending.” Based on a decade of producing cost-effectiveness evaluations, the Economic Evaluation and Public Health Committee (CEESP) issued two documents to frame its activity related to the economic evaluation of health products: (i) the new guidance highlights the expectations of the CEESP regarding cost-effectiveness evaluations; (ii) the doctrine elucidates the grading of methodological reservations expressed during the technical appraisal of manufacturers’ submissions, the CEESP’s statements regarding its findings, and the key messages it wishes to convey to public decision-makers, especially to negotiate healthcare product prices.MethodsWe aim at sharing the content of these documents and describing the willingness of the CEESP to support decision-makers in implementing evidence-based pricing policies.ResultsThe new guidance provided an opportunity for HAS to stress the importance of interpreting the evaluations, which are often perceived as highly technical. In this perspective, several guidelines call for more reasoned reflection on the objectives of the evaluation upon its conception, along with a constant effort to justify the methodological choices made and an extensive interpretation of the results produced.The doctrine highlights two steps taken by the CEESP, mainly built on analyzing the cost-effectiveness evaluation’s uncertainty. First, the ability to characterize the level of the ICER in a context where no thresholds for willingness-to-pay exist in France; second, the suggestion of specific regulation schemes to increase the cost-effectiveness of the products.ConclusionsThe CEESP developed the new guidance and its doctrine as conditions to ensure the usefulness of the economic evaluation for decision-making.