bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP39 Co-Creation Of A European Digital Health Technology Assessment Framework: The EDiHTA EU-Funded Project
Authors: Tsiasiotis Emmanouil , Di Bidino Rossella , Sacchini Dario , Cicchetti Americo 
Published: January 2025

IntroductionThe widespread adoption of digital health technologies (DHTs) brings new methodological challenges to health technology assessment (HTA). Different tools, guidelines, and methods have been defined by different stakeholders at national/international levels. In this scenario, the real thread for HTA is the lack of coordination and harmonization in the efforts to finalize the definition of an HTA framework for DHTs.MethodsThe European Digital Health Technology Assessment (EDiHTA) project aims to provide the first framework co-created by all stakeholders along the value chain for DHTs. The consortium is comprised of 15 partners from nine countries (Italy, the Netherlands, Denmark, Spain, Germany, Norway, UK, Belgium, and Poland). Stakeholders included are HTA agencies, regulators, hospitals, patient/citizen representatives, academics/universities, notified bodies, and developers. The project covers all types of DHTs and Technology Readiness Levels (TRLs). A multistakeholder, multidomain, and modular approach is adopted with the final goal to provide a validated, ready-to-use digital HTA framework for DHTs for the European ecosystem.ResultsThe EDiHTA is articulated in eight working packages and covers four years. Starting from the mapping of the current scenario, after the definition of a common taxonomy, EDiHTA will develop a DHT-dedicated HTA framework. A common digital platform to support the assessment will be developed. Both the HTA framework and platform will be tested, refined, and validated through a piloting process involving disparate DHTs (mApp, telemedicine, artificial intelligence, and others) with different TRLs, available in different countries, with the participation of all stakeholders. As a consequence, evidence requirements will be defined and made more transparent; this will support health technology.ConclusionsThe EDiHTA project will deliver the first European digital HTA framework able to support and inform decision-making (at the macro [policy], meso [management providers], and micro [clinicians] level) towards faster and safer access to DHTs of added value, taking European regulations and legal requirements into account and assessing all HTA domains.
PP63 Perspectives Of Physical And Organic Disability Organizations On Health Technology Assessment Processes
Authors: Lorenzo Laura Quintas , Suárez Isabel González , Gómez-Salgado Patricia , Faraldo Vallés María José 
Published: January 2025

IntroductionEffective participation of individuals with disabilities in health technology assessment (HTA) processes is paramount. Aware of the reality of people with physical and organic disabilities, COGAMI (a not-for-profit umbrella organization of disability associations) conducted an internal study to gather perspectives on the participation of people with disabilities in HTA processes.MethodsAn ad hoc questionnaire of four open-ended questions was designed and distributed via email to COGAMI’s socio-health commission, representing 23 entities and 4,000 people in Galicia. A thematic analysis of the responses obtained was carried out.ResultsConsensus underscores the fundamental role of individuals with disabilities and their representative organizations in HTA processes, though currently, only those with greater resources actively participate. The participants found that insufficient information reaching patient organizations hinders participation (e.g., lack of awareness in proposal submission), complicating their involvement. Additional challenges include accessibility and the digital divide. Proposed solutions involve enhancing communication channels and information accessibility, establishing collaborative frameworks nationally, and actively considering the disability condition to ensure a fair and equitable implementation.ConclusionsThis study suggests the need for concrete actions to enhance the participation of individuals with disabilities in HTA processes. Recommendations include improving communication channels, capacity building, and recognizing disability as a key element in HTA.
PP67 From Insight To Foresight: Singapore’s Experience In Horizon Scanning Of Medical Technologies
Authors: Ng Zhen Long , Ju Hong , Ng Jaryl , Soon Swee Sung , Ng Kwong 
Published: January 2025

Introduction
The Agency for Care Effectiveness (ACE) in Singapore has established a horizon scanning (HS) system to provide advance notice of new and emerging medical technologies (MedTechs) to inform service planning since 2020. To remain fit for purpose, HS needs to evolve over time to better serve its stakeholders. This abstract aims to share ACE’s early HS experience and future opportunities.Methods
To gather insights into ACE’s HS successes and potential gaps, a mixed-methods approach was used. A review of key HS activities was conducted, including different HS outputs produced, stakeholder engagements conducted, and dissemination strategies employed. Feedback from key stakeholders was gathered to understand the potential utility of our outputs. Lastly, potential gaps and opportunities were identified to inform future initiatives.ResultsAs of July 2023, 20 HS reports were developed, comprising three high-level overviews and 17 in-depth briefs. Output of briefs increased five-fold from 2021 (n=2) to 2023 (n=10). Efforts to drive impact included industry submission of pipeline MedTechs to supplement identification sources; report dissemination to over 100 policymakers and healthcare professionals for early service planning; and participation in network activities and conferences to share knowledge. Initial stakeholder feedback was positive, citing the reports’ relevance for clinical practice. The review recommended diversifying HS outputs to include environmental scan and trends reports, strengthening patient involvement and formal impact assessment through stakeholder surveys.Conclusions
ACE’s HS has made significant progress in achieving its intended objectives to enable service planning for new and emerging MedTechs. However, this remains an iterative process with new opportunities for growth. Future initiatives were identified, such as impact assessment, enhancing stakeholder engagement to include patients, and broadening outputs to meet stakeholder demands.
PP87 A Descriptive Study Of The Use Of Data Visualization In Full Health Technology Assessment Reports: 2021 To 2023
Authors: Ramos Estefania Herrera , Rodríguez-López Rocío , Isabel-Gómez Rebeca , Rosario Lozano María Piedad , Casal-Acción Beatriz , Peiró Roland Pastells , Galnares-Cordero Lorea 
Published: January 2025

IntroductionData visualization is a powerful communication tool to facilitate the understanding of a complex process or data. Data visualization has been used in health technology assessment (HTA) reports for a long period (e.g., PRISMA flow diagrams, critical assessments, or GRADE). This study aims to investigate the number and manners in which HTA reports have been using descriptive data visualization for the years 2021 to 2023.MethodsThe international HTA database was used to identify and download the HTA reports from the years 2021 to 2023. We applied the database limits: full HTA and completed reports. The records were imported into a Microsoft Excel spreadsheet and screened by eight independent researchers applying the inclusion criteria: full HTA (according to methodological definition), access to the full text, and use of data visualization with a descriptive purpose (we excluded PRISMA flow diagrams, forest plots, and others). The data were observed with the software Power BI. Our analysis included variables such as agency name, country, section, type of visualization, and software.ResultsFrom the international HTA database, 1,128 records were exported: 89 records were directly excluded from this set as they were tagged as ongoing or other types of reports in the database; 1,039 records were screened. Around 30 percent of records were included for the data visualization screening criteria after fulfilling our inclusion criteria (full HTA and available full text). Finally, 12 percent of the reports included data visualizations for a descriptive purpose of their results or conclusions. The countries with a higher number of records included in this analysis were Germany (28%), Canada (18%), the UK (16%), and Spain (11%).ConclusionsIn our sample, we observed that data visualization is not widely used so far to describe outcomes and/or conclusions from HTA reports. An additional finding was the number of records tagged as full HTA in the international HTA database that were excluded as non-full HTA from our study.
PD02 Budget Impact Analysis: A Challenge To Incorporating Medications For Ultrarare Diseases In The Brazilian Healthcare System
Authors: Santos Marisa , da Silva Pereira Curado Daniel , Machado-Rugolo Juliana , Komoda Denis Satoshi , de Paula De Sordi Mônica Aparecida , Fonseca Alan Francisco , Coneglian de Almeida Juliana Tereza , Lima Silvana Molina , Theresa Weber Silke Anna , Tarride Jean-Eric , Thabane Lehana , de Almeida Cardoso Marilia Mastrocolla , Modelli de Andrade Luis Gustavo 
Published: January 2025

IntroductionThe decision-making process for incorporating technologies for ultrarare diseases (URD) has been a challenge for health technology assessment agencies worldwide. These challenges have been presented in debates about the budget impact of incorporating technologies for URD. This is an important issue because there are other dimensions of the economic and social impact of URD that require consideration.Methods
Data were extracted from National Committee for Health Technology Incorporation (CONITEC) reports (2012 to 2022) on technologies for the treatment of URD in Brazil. Diseases were classified using an epidemiological criterion or Orphanet consultation (prevalence ≤1 per 50,000 inhabitants). Variables included eligible patient count, population estimation method, incremental impact values for one and five years, and diffusion rate in the first and fifth year. Univariate logistic regression was used to adjust the relationship between the budget impact analysis and the final recommendation, considering factors associated with incorporation in univariate regression and p-values less than 0.10 in a multivariate regression.ResultsAmong 53 reports, 48 percent exclusively employed the epidemiological approach for incremental impact assessment population estimation, rising to 69.5 percent when combined with measured demand. Population data were nearly evenly sourced from national and international platforms, with the UK, the USA, and multicenter studies being the most cited internationally. Notable differences were found between favorable and unfavorable CONITEC recommendations, with lower values being associated with incorporation. Market share diffusion rates favored the option of 100 percent diffusion in both the first year and the cumulative five years. The analysis highlighted the influence of demand characteristics and technology type on the budget impact value over one and five years.ConclusionsThe study found that budget impact data significantly influenced the final recommendation for technology incorporation, indicating a criterion favoring technologies with a lower budget impact. However, requester characteristics and technology type also played a role in the decision-making process, suggesting that additional factors influence recommendations.
PD03 Exploring Expenditure On State Subsidized Medicines in Ireland Between 2018 And 2022: Special Focus On Cancer Drug Expenditure
Authors: Walsh Caroline , Trela-Larsen Lea , Adams Roisin 
Published: January 2025

IntroductionThe Department of Health in Ireland published a review of expenditure on state subsidized medicines in August 2021. Detailed analysis indicated exponential growth of expenditure on cancer drugs administered in the community. However, expenditure by drug group across all state subsidized schemes, including hospitals, was not explored.MethodsUsing national reimbursement claims data, total medicines expenditure on community drug schemes (CDS) was analyzed annually for the years 2018 to 2022. The total drug expenditure stratified by anatomical therapeutic class (ATC) code was calculated. Expenditure on cancer drugs (ATC code L) between 2018 and 2022, including hospital data, was further explored. Cancer drugs with the highest expenditure were identified, and trends in their expenditure were analyzed. Dates of European regulatory approval, completion of health-technology assessments by the National Centre for Pharmacoeconomics in Ireland, and reimbursement by the Health Service Executive for the identified cancer drugs were collected.ResultsThe total expenditure on drugs on CDS rose from EUR1.74 billion (EUR1.61 billion excluding value-added tax [VAT]) in 2018 to EUR2.2 billion (EUR2.03 billion excluding VAT) in 2022. Expenditure on antineoplastic and immunomodulatory agents (ATC code L) rose from 34 percent in 2018 to 38 percent in 2022. The cancer drugs with the highest cumulative expenditure on hospital schemes were pembrolizumab (EUR98.41 million excluding VAT), nivolumab (EUR75.15 million), daratumumab (EUR54.05 million), and trastuzumab (EUR41.48 million). All the aforementioned drugs demonstrated year-on-year increases in annual expenditure apart from nivolumab. Expenditure on pembrolizumab increased by 48 percent in 2022, compared with 2021.ConclusionsExpenditure on state subsidized medicines is increasing annually, although confidential discounts may reduce budget impact. Increasing expenditure may be attributed to the expansion of existing indications and increasing patient volume. Expenditure on monoclonal antibodies is substantially larger than expenditure on other drugs. Pembrolizumab was reimbursed for six additional indications in 2021, contributing to the sharp increase in expenditure between 2021 and 2022.
PD06 Automated Systems For Hospital Inpatient Safety: A Cost-Utility Analysis
Authors: Holmes Emily , Williams Huw Lloyd , Hughes Dyfrig , Naujokat Elke , Duller Bernd , Subbe Christian 
Published: January 2025

IntroductionDeployment of an electronic automated advisory vital signs monitoring and notification system to signal clinical deterioration is associated with significant improvement in clinical outcomes. This study aimed to estimate the incremental cost per quality-adjusted life-year (QALY) gained with an electronic automated advisory notification system, compared with standard care.MethodsA decision analytic model was developed to estimate the cost effectiveness of an electronic automated advisory notification system, compared with standard care, in adults admitted to a district general hospital. Analyses considered the following: (i) cost effectiveness (cost/event avoided) based on a before-and-after study (n=3,787) that recorded rates of acute myocardial infarction, pulmonary embolism, acute pulmonary edema, respiratory failure, stroke, severe sepsis, acute renal failure, cardiopulmonary arrest, admission to the intensive care unit, and death; and (ii) the cost utility (cost per QALY) over a lifetime horizon extrapolated using published data. The analysis was conducted from the perspective of the National Health Services (NHS) in the UK.ResultsThe automated notification system was more effective (2.7 fewer events per 100 patients) and provided cost savings of −GBP12.17 [−EUR14.07] per patient admission (95% CI: −GBP182.07 [−EUR211.20], GBP154.80 [EUR179.57]). The automated notification system was dominant over a lifetime horizon, demonstrating a positive incremental QALY gain (0.0287 QALYs, equivalent to approximately 10 days of perfect health) and a cost saving of −GBP55.35 (−EUR64.02). At a threshold of GBP20,000 per QALY (EUR23,126), the probability of automated monitoring being cost effective in the NHS was 0.81. The increased use of cableless sensors may reduce cost-savings, but the intervention remained cost effective at 100 percent usage (incremental cost-effectiveness ratio GBP3,107 per QALY [EUR3,594 per QALY]).ConclusionsAn automated notification system for adult patients admitted to general wards appears to be a cost-effective strategy in the NHS. The analysis suggests that adopting this technology could be good use of scarce resources. The impact of automated monitoring solutions on staffing warrants further exploration and may show additional value in adopting such technology.
PD07 Can Commencing Colorectal Cancer Screening At Age 45 Years Be A Good Investment? An Individual-Level Simulation Analysis In Germany
Authors: Lwin Min Wai , Cheng Chih-Yuan , Calderazzo Silvia , Schramm Christoph , Schlander Michael 
Published: January 2025

IntroductionThe effectiveness and cost saving advantages of colorectal cancer (CRC) screening have gained widespread scientific consensus. However, the rising incidence of early-onset CRC has challenged Germany’s current screening program, which focuses on individuals aged 50 years or older. This study evaluated the potential cost effectiveness of initiating CRC screening in Germany at the age of 45 years.MethodsThe cost-effectiveness analysis utilized a validated discrete-event-simulation model, DECAS, which incorporates both adenomatous and serrated polyp pathways in CRC development. This model has been validated using German CRC epidemiological data and simulates the effects of screening interventions. It was used to compare four new CRC screening strategies starting at age 45 years (10-yearly colonoscopy, annual or biennial fecal immunochemical testing [FIT], or both) with the current screening strategy starting at age 50 years. The simulation, assuming perfect adherence, included a cohort of 100,000 individuals with an average CRC risk from age 20 to 90 years or death, applying a three percent discount with costs in 2023 Euros.Results
The model outcomes included quality-adjusted life-years (QALYs) gained and total incremental costs, considering both CRC treatment and screening costs. Initiating 10-yearly colonoscopy only or FIT plus colonoscopy strategies at age 45 years yielded incremental gains of seven to 28 QALYs, with incremental costs of EUR28,360 to EUR71,759 per 1,000 individuals, compared with the current strategy. The incremental cost-effectiveness ratios varied between EUR1,029 and EUR9,763 per QALY gained. The FIT-only strategy was dominated by the current screening strategy. These findings remained consistent throughout the probabilistic sensitivity analyses.ConclusionsThe cost-effectiveness findings support initiating CRC screening at age 45 years with either colonoscopy alone or colonoscopy plus FIT, demonstrating substantial gains in QALYs and a modest increase in costs. Our findings emphasize the importance of implementing CRC screening five years earlier than the current practice to achieve more significant health and economic benefits.
PD12 Cost Effectiveness Analysis Of Nivolumab Plus Ipilimumab For First-Line Treatment Of Advanced Non-Small Cell Lung Cancer In China
Authors: Xiao Dunming , Chen Yingyao , Yang Yi 
Published: January 2025

IntroductionNon-small cell lung cancer (NSCLC) is the most prevalent malignant tumor in China. This study aimed to compare the cost effectiveness of combined nivolumab and ipilimumab with chemotherapy as a first-line treatment for advanced NSCLC. The findings will contribute to the economic evidence for making clinical and health policy decisions.MethodsTaking a healthcare system perspective, this study used a partitioned survival analysis model to simulate the disease trajectory of advanced NSCLC during first-line treatment over a model cycle of three weeks. The simulation extended over a span of 12 years. A five percent discount was incorporated for both costs and health outcomes. Published clinical efficacy and cost data were extracted from the CheckMate 9LA study (NCT03215706) and drug pricing information was gathered from the YaoZhi website. Utility values were derived from 13 tertiary hospitals in five provinces of China. Base case and sensitivity analyses were also conducted.ResultsThe combination of nivolumab and ipilimumab resulted in a lifetime cost of CNY850,068 (USD119,127) and 1.796 quality-adjusted life-years (QALYs), whereas chemotherapy incurred a lifetime cost of CNY276,313 (USD38,722) and a gain of 1.206 QALYs. The incremental cost-effectiveness ratio (ICER) for combination therapy was CNY971,955 (USD136,208) per QALY gained, which was more than three times the average gross domestic product per capita in China (CNY85,698 [USD12,010] in 2022) and indicated that the therapy was not cost effective. Probabilistic sensitivity analysis indicated that the likelihood of nivolumab plus ipilimumab being cost effective, compared with chemotherapy, was 0.02.ConclusionsNivolumab plus ipilimumab demonstrated enhanced health outcomes for patients with advanced NSCLC, compared with standard chemotherapy, but the ICER exceeded the acceptable threshold, suggesting that the treatment is not cost effective.
PD13 Cost Effectiveness Of Imipenem-Cilastatin-Relebactam Compared With Colistina-Imipenem For Treating Confirmed Carbapenem Non-Susceptible Gram-Negative Bacterial Infections
Authors: Paoletti Martina , Marcellusi Andrea , Yang Joe , Mennini Francesco Saverio 
Published: January 2025

IntroductionAntimicrobial resistance is an important public health problem with a strong epidemiological, economic, and social impact. The objective of this analysis was to compare the cost effectiveness of imipenem-cilastatin-relebactam (IMI/CIL/REL) therapy with colistin-imipenem for the treatment of hospitalized patients with Gram-negative bacterial infection caused by imipenem-resistant pathogens.MethodsThe population comprised patients with hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia that was complicated with an intra-abdominal or urinary tract infection caused by carbapenem-resistant Gram-negative pathogens. The model started with a short-term decision tree describing possible treatment routes and outcomes for patients during hospitalization. After treatment, patients were classified as cured, not cured, or dead. Patients who had not responded to the initial treatment received another line of therapy. Successfully treated patients were entered into the long-term Markov model, which captured follow-up costs and health-related quality of life over their lifetimes.ResultsThe analysis was conducted on a hypothetical cohort of 1,000 patients and demonstrated that IMI/CIL/REL therapy was advantageous in terms of diagnosis and treatment in the short term as well as cost effectiveness. In fact, IMI/CIL/REL therapy was dominant, compared with colistin-imipenem, from the National Health System and the societal perspective, providing an average saving of EUR2,800.15 and EUR3,174.63, respectively, and gains of 4.76 years of life and 4.12 quality-adjusted life-years per patient.ConclusionsThanks to its economic and societal value, IMI/CIL/REL therapy represents an investment in health that is lifesaving in critically ill patients and is a valuable public health tool in the fight against antimicrobial resistance.