A Roadmap to the Use of Value of Information Analysis in Health Technology Assessment: An International Study of Barriers, Facilitators, and Potential Applications

OBJECTIVES: Value of information (VOI) analysis represents a pivotal method to quantify uncertainty in decisions about the reimbursement of new health technologies. Despite its significance, VOI remains underutilized by Health Technology Assessment (HTA) agencies worldwide. This study aims to provide an overview of the potential applications and barriers to the integration of VOI within HTA processes across diverse jurisdictions and develops recommendations on how to integrate VOI in HTA processes.

METHODS: We mapped HTA processes across several jurisdictions, including Australia, Canada, England & Wales, the Netherlands, and Norway. First, we performed a scoping review on barriers and facilitators to VOI use in practice. Second, we developed a questionnaire through collaboration with Collaborative Network for Value of Information (ConVOI) members. Third, for each jurisdiction included, the questionnaire was completed based on publicly available information, the authors’ experience and consultations with HTA agencies. Finally, we performed thematic analysis on barriers in these processes and developed recommendations in a workshop.

RESULTS: From October 2024, the Netherlands are the only country requiring VOI as part of HTA submissions among the jurisdictions considered. We identified barriers related to stakeholder attitudes and knowledge, analysis- and process-related barriers. VOI had three main uses, for 1) risk assessment, 2) identification of risk drivers, and 3) evaluation of research. ConVOI recommendations include strategies for communication and dissemination of VOI and ideas for designing HTA processes to accommodate VOI. For use 3), we provide recommendations for coverage with evidence development frameworks.

CONCLUSIONS: We developed a roadmap to VOI use in HTA processes, which relies on the most comprehensive study of barriers and facilitators to VOI use to date. The recommendations made may have the potential to facilitate the practical implementation of VOI analysis within HTA processes and may help exploit its potential for risk assessment, identification of risk drivers and evaluation of research.