Presentation (CTI)

OBJECTIVES: This study aims to redefine the framework for health technology assessment (HTA) in Europe by proposing a broader, multidimensional approach to evaluating the value of health products. Traditional cost-effectiveness models often overlook important dimensions such as organizational, societal, environmental, and patient-reported impacts, which are critical to informed public decision-making.
METHODS: A review of the evolution of HTA practices internationally was conducted, focusing on the integration of new value dimensions into decision-making frameworks. Examples of multidimensional models, including those using budgetary and organizational impact analyses, were analyzed to illustrate their potential. The study introduces a comprehensive value equation: Global Value of Health Products = BC + E + IB + IO + IS + IE + VIP + EP ,
where:
- BC: Clinical Benefit,
- E: Efficiency Level,
- IB: Budget Impact,
- IO: Organizational Impact,
- IS: Societal Impact,
- IE: Environmental Impact,
- VIP: Value of Information for Patients,
- EP: Experience of Patients and Caregivers.
RESULTS: Analysis of case studies demonstrated that integrating dimensions such as organizational and societal impacts strengthens the decision-making process. For instance, the application of organizational and budgetary impact models (OBIM) highlighted their utility in assessing technologies with complex implications for care pathways. Additionally, methods like Multi-Criteria Decision Analysis (MCDA) have shown that prioritizing patient and societal preferences leads to more equitable and sustainable resource allocation.
CONCLUSIONS: HTA frameworks in Europe must evolve to reflect the multifaceted value of health innovations, beyond clinical and cost dimensions. Incorporating organizational, societal, and environmental impacts, alongside patient experience and preferences, ensures decisions are aligned with broader public health objectives. Such an approach enables a more transparent and equitable allocation of resources while addressing the ethical challenges posed by binary decision thresholds.