HTA Conflicts in Europe: Agreeing to Disagree?

Author(s)

Christianah Edema, MBBS, Jay Bilimoria, PhD, Alison Martin, MSc, MD, Kalliopi Roussi, PhD.
Crystallise Ltd, Colchester, United Kingdom.
OBJECTIVES: Obtaining approval by Health Technology Assessment (HTA) bodies is crucial for market access for a new product, but approval rates vary by location. We aimed to compare decisions on the same cancer technologies for the same indications by the most prolific European HTA bodies.
METHODS: We assessed all decisions published by 24 HTA bodies internationally from May 2023 to April 2025 using data from the HTAngel newsletter (https://www.crystallise.com/htangel/). Final decisions from NICE in England, HAS in France, IQWiG in Germany and SMC in Scotland were compared for interventions assessed for the same cancer indication. Terminated applications were classed as non-approvals.
RESULTS: Across all HTA bodies, 697 decisions were made on cancer technologies, with 52% resulting in approvals. NICE approved 66% of 93 decisions, HAS 67% of 89, IQWiG 40% of 149, and SMC 64% of 75. Among 75 technologies reviewed by more than one agency, 31% were approved by all, 15% rejected by all, and 55% had mixed outcomes. HAS showed the highest consistency, aligning with other agencies 50 to 63% of the time. NICE agreed with IQWiG on 37% and with SMC on 88% of overlapping technologies, while IQWiG and SMC aligned 41% of the time. IQWiG was the most likely to issue multiple decisions on a single technology, changing its stance in 38% of such cases.
CONCLUSIONS: Although NICE and SMC generally agree with each other, there is otherwise little agreement between the main European HTA bodies about cancer technologies, with most disagreements being with IQWiG. A previous decision by one body is a poor predictor of subsequent decisions.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

HTA184

Topic

Health Policy & Regulatory, Health Technology Assessment, Organizational Practices

Topic Subcategory

Decision & Deliberative Processes

Disease

Oncology

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