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Desmet T, Brijs M, Vanderdonck F, Tops S, Simoens S, Huys I. Implementing the EU HTA regulation: Insights from semi-structured interviews on patient expectations, Belgian and European institutional perspectives, and industry outlooks. Front Pharmacol 2024; 15:1369508. [PMID: 38659588 PMCID: PMC11039851 DOI: 10.3389/fphar.2024.1369508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction: The goal of the Health Technology Assessment (HTA) Regulation 2021/2282 is to establish a more harmonized HTA framework, fostering member states cooperation and enabling equal patient access to innovative health technologies in Europe. This research aimed to assess the impact of the regulation on national HTAs, the strategic implications for health technology developers, and its influence on price and reimbursement negotiations. Methods: A scoping literature review encompassing peer-reviewed literature as well as grey literature was conducted. Between February and March 2023, semi-structured interviews (n = 20) were performed with stakeholders from Belgian governmental institutions, European institutions, advanced therapy medicinal product developers, academics, and sickness funds. The interviews were analyzed using the framework analysis method. Results: Numerous steps, such as the development of implementing acts and procedural guidelines remain to be taken. At member state level, national/regional HTA bodies and payers must act to adopt the new concepts of Joint Scientific Consultations (JSC) and Joint Clinical Assessments (JCA) within their national legislation, as well as revise their timelines and prepare for interactions at a European level. Compiling a harmonized PICO (Population, Intervention, Comparator, and Outcome), adapting local procedures, and increasing capacity to actively take part in the JSC and JCA are seen as primary barriers by several stakeholders. Training and education will help HTA bodies, payers, and health technology developers to participate in the European processes. Conclusion: While practical and legal challenges were identified, recommendations (such as actively preparing for the upcoming changes and increasing capacity while providing training) were provided to adapt national and European procedures to the needs of the HTA Regulation 2021/2282. The importance of fostering collaborations and aligning local HTA procedures with the new way of working set out by the Regulation was demonstrated with this study.
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Affiliation(s)
- Thomas Desmet
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Healthcare Management Centre, Vlerick Business School, Ghent, Belgium
| | - Maud Brijs
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | | | - Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Van Haesendonck L, Ruof J, Desmet T, Van Dyck W, Simoens S, Huys I, Giuliani R, Toumi M, Dierks C, Dierks J, Cardone A, Houÿez F, Pavlovic M, Berntgen M, Mol PG, Schiel A, Goettsch W, Gianfrate F, Capri S, Ryan J, Ducournau P, Solà-Morales O, Julian E. The role of stakeholder involvement in the evolving EU HTA process: Insights generated through the European Access Academy's multi-stakeholder pre-convention questionnaire. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2023; 11:2217543. [PMID: 37284060 PMCID: PMC10240997 DOI: 10.1080/20016689.2023.2217543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
Involvement of all relevant stakeholders will be of utmost importance for the success of the developing EU HTA harmonization process. A multi-step procedure was applied to develop a survey across stakeholders/collaborators within the EU HTA framework to assess their current level of involvement, determine their suggested future role, identify challenges to contribution, and highlight efficient ways to fulfilling their role. The 'key' stakeholder groups identified and covered by this research included: patients', clinicians', regulatory, and Health Technology Developer representatives. The survey was circulated to a wide expert audience including all relevant stakeholder groups in order to determine self-perception by the 'key' stakeholders regarding involvement in the HTA process (self-rating), and in a second, slightly modified version of the questionnaire, to determine the perception of 'key' stakeholder involvement by HTA bodies, payers, and policymakers (external rating). Predefined analyses were conducted on the submitted responses. Fifty-four responses were received (patients 9; clinicians: 8; regulators: 4; HTDs 14; HTA bodies: 7; Payers: 5; policymakers 3; others 4). The mean self-perceived involvement score was consistently lower for each of the 'key' stakeholder groups than the respective external ratings. Based on the qualitative insights generated in the survey, a RACI Chart (Responsible/Accountable/Consulted/Informed) was developed for each of the stakeholder groups to determine their roles and involvement in the current EU HTA process. Our findings suggest extensive effort and a distinct research agenda are required to ensure adequate involvement of the key stakeholder groups in the evolving EU HTA process.
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Affiliation(s)
| | - Jörg Ruof
- r-connect Ltd, Basel, Switzerland
- Medical School of Hanover, Hanover, Germany
| | - Thomas Desmet
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Healthcare Management Centre, Vlerick Business School, Brussels, Belgium
| | - Walter Van Dyck
- Healthcare Management Centre, Vlerick Business School, Brussels, Belgium
| | - Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Rosa Giuliani
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Mondher Toumi
- Faculty of Medicine, Public Health Department, Aix-Marseille University, Marseille, France
| | | | | | | | - Francois Houÿez
- European Organisation for Rare Diseases (EURORDIS), Paris, France
| | - Mira Pavlovic
- Medicines Development and Training (MDT) Services, Paris, France
| | - Michael Berntgen
- Scientific Evidence Generation department, European Medicines Agency (EMA), Amsterdam, The Netherlands
| | - Peter G.M. Mol
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Anja Schiel
- Norwegian Medicines Agency (NOMA), Oslo, Norway
| | - Wim Goettsch
- National Health Care Institute, Diemen, The Netherlands
| | - Fabrizio Gianfrate
- University of Ferrara, Ferrara, Italy
- School of Economics and Management, Cattaneo-LIUC University, Castellanza, Italy
| | - Stefano Capri
- Health Economics and Payer Evidence, Astra Zeneca, Cambridge, UK
| | - James Ryan
- Global Market Access & Pricing, Abbvie AG, Cham, Switzerland
| | - Pierre Ducournau
- HiTT Foundation, International University of Catalonia-UIC, Barcelona, Spain
| | - Oriol Solà-Morales
- Utrecht Centre for Pharmaceutical Policy, Division of Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, Utrecht, The Netherlands
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