Presentation (CTI)

OBJECTIVES: The purpose of health technology assessment (HTA) agencies globally is to make evidence-based evaluations of the value of new health interventions. Increasingly, HTA agencies ask manufacturers to include reference to health equity in their submissions. Following an earlier pilot study, this study aims to understand how frequently HTA agencies (United Kingdom, Canada and Australia) ask manufacturers to provide evidence relating to health equity, and how frequently they refer to that evidence in their assessment reports.
METHODS: A comparison of the most recent HTA agency guidance (including submission templates) and assessment reports was undertaken to assess the nature of health equity-related guidance. Evaluation was performed to assess the presence and role of health-equity related drivers and detractors of value in HTA assessments by NICE, CDA and PBS in 2024. All 57 pharmaceuticals assessed in single technology appraisals (STAs) by NICE in 2024/5 served as the index list for review of assessments by all three agencies. We considered elements of value in two broad categories; therapy area-related value (e.g. investment in indications that disproportionately impact vulnerable or underserved populations) and intervention-related value (including clinical trial diversity, patient support initiatives, and intrinsic features of the intervention that may impact equitable access).
RESULTS: Our analysis found evidence for health equity considerations impacting HTA decision making. The frequency with which equity is referenced within assessment reports varies between countries; of NICE, CDA, and PBAC, NICE most consistently states how health equity-related deliberations have impacted the assessment outcome.
CONCLUSIONS: Health equity considerations may impact the overall recommendation, or the size of the population recommended for reimbursement. As equity-related economic modeling methodologies mature, it may be that agency requirements around equity data submitted become more prescriptive.