Health Technology Assessment (HTA) Systems and Risk Identification Strategies: A Comparative Analysis Across Western European Countries, Canada, and Australia
Author(s)
Max van Wijk, MSc, Janke-Renée Muryango, MSc, Pauline Pasman, MSc.
IQVIA, Amsterdam, Netherlands.
IQVIA, Amsterdam, Netherlands.
OBJECTIVES: The Ministry of Health in the Netherlands has developed an action plan to improve the current reimbursement system, structured into five phases: horizon scan, risk identification, rapid review and triage, risk mitigation, and re-assessments. This study aimed to describe and analyze health technology assessment (HTA) systems in other countries to understand the risk identification strategies and reimbursement pathways utilized, intended to inform the potential HTA system reformations in the Netherlands.
METHODS: The initial phase of this analysis entailed describing the HTA systems of twelve countries (the Netherlands, Belgium, France, Spain, Germany, Italy, Norway, Sweden, United Kingdom, Ireland, Canada, and Australia). A more detailed analysis was subsequently conducted for Ireland, Norway, and Canada, focusing on risk identification strategies, methods for risk assessment, utilization of horizon scanning, types and criteria for risks, and the integration of risk analyses into the HTA process.
RESULTS: In half of the included countries (6 out of 12) a single authority is responsible for the HTA, while multiple authorities are involved in the remaining countries. The majority of countries (67%; 8 out of 12) incorporate horizon scanning into their HTA processes. Only four countries (the Netherlands, Norway, Sweden, and Ireland) employ specific risk identification strategies to guide reimbursement procedures for particular therapies. The Netherlands stands out for its clear and normative criteria dictating the HTA procedure, with decisions based on financial risks prior to the assessment. Other countries utilize other criteria, including relative effectiveness, innovation, and disease burden, as risk identification strategies. The Netherlands is one of the only countries that do not allow for any flexibility after a reimbursement pathway is determined for a specific therapy.
CONCLUSIONS: These findings offer valuable insights into HTA systems across different countries and provide a basis for further discussions on the evolution of the reimbursement system in the Netherlands.
METHODS: The initial phase of this analysis entailed describing the HTA systems of twelve countries (the Netherlands, Belgium, France, Spain, Germany, Italy, Norway, Sweden, United Kingdom, Ireland, Canada, and Australia). A more detailed analysis was subsequently conducted for Ireland, Norway, and Canada, focusing on risk identification strategies, methods for risk assessment, utilization of horizon scanning, types and criteria for risks, and the integration of risk analyses into the HTA process.
RESULTS: In half of the included countries (6 out of 12) a single authority is responsible for the HTA, while multiple authorities are involved in the remaining countries. The majority of countries (67%; 8 out of 12) incorporate horizon scanning into their HTA processes. Only four countries (the Netherlands, Norway, Sweden, and Ireland) employ specific risk identification strategies to guide reimbursement procedures for particular therapies. The Netherlands stands out for its clear and normative criteria dictating the HTA procedure, with decisions based on financial risks prior to the assessment. Other countries utilize other criteria, including relative effectiveness, innovation, and disease burden, as risk identification strategies. The Netherlands is one of the only countries that do not allow for any flexibility after a reimbursement pathway is determined for a specific therapy.
CONCLUSIONS: These findings offer valuable insights into HTA systems across different countries and provide a basis for further discussions on the evolution of the reimbursement system in the Netherlands.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA173
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas