Navigating a Maze of Indirect Treatment Comparisons: How to Ensure We Have Selected the Ideal Method for a Decision-Problem

Issue The proliferation of complex therapies, numerous comparators and evolving evidence requirements have made indirect treatment comparisons (ITCs) indispensable in HTA. Since ISPOR’s 2014 Task Force guidance, various new statistical techniques have been developed to help deal with reconciling heterogeneous data to HTA evidentiary standards. However, methodological choices remain contentious, and their implementation can sometimes introduce almost as much uncertainty as it resolves. Overview This panel will debate methodological rigor, transparency, and decision-making frameworks for ITCs in HTA. Dr. Hugo Pedder, University of Bristol, will present a pragmatic flow diagram to guide model selection in ITC, based on data availability and decision context, with clear references to alignment with different HTA body requirements. Dr Lara Wolfson, MSD, will present the complexity and challenges of balancing methodological ideals as statistical leaders in pharmaceutical industry versus diverse and rigorous requirements from HTA agencies globally to ensure transparent, consistent communication of the relative value of the health technology being assessed to multiple stakeholders. Dr Nicole Mittman, CDA-AMC, will present the HTA perspective on the evidence and methodology expectations to support comparison to other competing health technologies and for robust HTA decision-making, elucidating key trigger points when/how HTA agencies may update their guidance with new methods requirements. The panel will be moderated by Professor Kate Ren, University of Sheffield. The session will allocate 15 minutes per speaker, followed by 20 minutes of moderated debate on the following topics: 1. Whether current guidance adequately addresses emerging methods in ITC 2. The importance validating novel ITC approaches and assessing their robustness 3. The urgent need for updated guidance to harmonize standards across stakeholders