Presentation (CTI)

OBJECTIVES: Value assessment policies and collaborations, such as EUnetHTA, JCA and MFN, highlight opportunities for methods alignment across geographies. We examined cross-jurisdictional consistency in health utility measurement recommendations across 9 HTA agencies: ICER (US), CADTH (Canada), NICE (UK), HAS (France), IQWiG (Germany), AIFA/AGENAS (Italy), AEMPS (Spain), CONITEC (Brazil), and C2H (Japan).
METHODS: Utility-relevant guidance documents were identified via HTA websites and literature searches (2015-2025). Final English or translated guidance covering utility measurement for economic evaluations were included. Extracted data included required or preferred utility measures, acceptance of alternatives, country-specific value sets, mapping policies, pediatric/caregiver guidance, and references to other HTA frameworks. Descriptive analyses were conducted.
RESULTS: Fourteen guidance documents were identified across the 9 agencies, with 57% published or updated after 2022. Only HAS mandates use of a specific adult utility instrument (EQ-5D-5L). All other agencies prefer EQ-5D but do not mandate a version, with stated preferences varying (UK: EQ-5D-3L; France/Japan: EQ-5D-5L). All agencies accept alternative measures, including HUI, SF-6D, and disease-specific preference-based measures, when appropriately justified. Mapping from disease-specific or non-preference-based instruments to generic preference-based measures is permitted by 8/9 agencies, while IQWiG discourages mapping. Population-specific considerations were referenced in 6/9 agencies, most often caregiver guidance; pediatric-specific guidance was identified in 3/9, most commonly recommending EQ-5D-Y (Brazil specifies EQ-5D-Y-3L with local value sets). Country-specific value sets are required across all agencies. ICER and CADTH reference international HTA methods (including NICE) while maintaining internal guidance.
CONCLUSIONS: Utility measurement guidance is increasingly available across HTAs, but cross-jurisdiction usability remains uneven. Broad preference for EQ-5D and acceptance of alternatives supports partial harmonization, while variation in instrument versions, mapping acceptability, and pediatric/caregiver recommendations highlight opportunities to strengthen methodological alignment.