TY - JOUR
T1 - HTA reshaping
T2 - rethinking the health technology assessment framework in Portugal
AU - Pereira, João
AU - Alves, Joana
AU - Rodrigues, Bernardo
AU - Caetano, Ricardo
AU - Brito-Cruz, Pedro
AU - Sousa, Joana
AU - Barata, Branca
N1 - Funding Information:
MEA and MIP. These methods might be a relevant mechanism to improve access. However, they should be supported by an improved registry database. Participants identified the possibility of these databases being (partially) funded by the pharmaceutical industry. MIP implementation must be assured by accurate prescription tracking.
Publisher Copyright:
© 2021 The Author(s). Published by S. Karger AG, Basel on behalf of NOVA National School of Public Health.
PY - 2021
Y1 - 2021
N2 - Introduction: Health technology assessment (HTA) aims to provide decision makers with relevant data to make informed choices. Recent changes in the Portuguese HTA framework have altered substantially the assessment methodology with regard to economic evaluation, with potential impacts on access and process efficiency. The HTA Reshaping Project had as its main objective informing the debate on HTA in Portugal, thereby identifying improvement opportunities and solutions to the HTA framework that address future challenges. Methods: The project comprised several phases, i.e., (1) mapping and evaluation of different HTA frameworks across Europe, identifying best practices and key variables to consider in future frameworks; (2) conduction of in-depth interviews with relevant stakeholders (n = 11); and (3) development of 2 workshops - one with young professionals (n = 12) and another with relevant HTA stakeholders (n = 19) - to consolidate and further explore vital elements of HTA, aimed at brainstorming ideas and developing solutions to improve some of the most critical points, with a view to addressing future challenges. Results: The comparison of HTA frameworks showed that their purpose and sophistication vary across European countries. For example, the need for economic evidence is not unanimous, and reimbursement agreements vary considerably. Among the stakeholders interviewed there was a high level of agreement on priorities that should be addressed, e.g., expanding and creating national level registries and assuring patient participation throughout the HTA process. The possibility of using managed entry agreements to enhance patients' access, applying multi-indication pricing for medicines with different therapeutic values per indication, and improvement of registry/system interoperability gathered a moderate level of agreement. Conclusions: The Portuguese HTA framework might be further adapted to upcoming challenges and should evolve to improve access to innovative therapies. There is still a long path towards the convergence of HTA frameworks in EU member states.
AB - Introduction: Health technology assessment (HTA) aims to provide decision makers with relevant data to make informed choices. Recent changes in the Portuguese HTA framework have altered substantially the assessment methodology with regard to economic evaluation, with potential impacts on access and process efficiency. The HTA Reshaping Project had as its main objective informing the debate on HTA in Portugal, thereby identifying improvement opportunities and solutions to the HTA framework that address future challenges. Methods: The project comprised several phases, i.e., (1) mapping and evaluation of different HTA frameworks across Europe, identifying best practices and key variables to consider in future frameworks; (2) conduction of in-depth interviews with relevant stakeholders (n = 11); and (3) development of 2 workshops - one with young professionals (n = 12) and another with relevant HTA stakeholders (n = 19) - to consolidate and further explore vital elements of HTA, aimed at brainstorming ideas and developing solutions to improve some of the most critical points, with a view to addressing future challenges. Results: The comparison of HTA frameworks showed that their purpose and sophistication vary across European countries. For example, the need for economic evidence is not unanimous, and reimbursement agreements vary considerably. Among the stakeholders interviewed there was a high level of agreement on priorities that should be addressed, e.g., expanding and creating national level registries and assuring patient participation throughout the HTA process. The possibility of using managed entry agreements to enhance patients' access, applying multi-indication pricing for medicines with different therapeutic values per indication, and improvement of registry/system interoperability gathered a moderate level of agreement. Conclusions: The Portuguese HTA framework might be further adapted to upcoming challenges and should evolve to improve access to innovative therapies. There is still a long path towards the convergence of HTA frameworks in EU member states.
KW - Economic evaluation
KW - Health financing
KW - Health technology assessment
KW - Innovative medicines
KW - Market access
U2 - https://doi.org/10.1159/000516501
DO - https://doi.org/10.1159/000516501
M3 - Article
SN - 2504-3145
VL - 39
SP - 36
EP - 47
JO - Portuguese Journal of Public Health
JF - Portuguese Journal of Public Health
IS - 1
ER -