Presentation (CTI)

OBJECTIVES: We aimed to identify and assess literature discussing the interplay between RWE, health equity, and HTA/health economics and outcomes research (HEOR), for the promotion of equitable access to healthcare and improved patient outcomes.
METHODS: Search terms for health equity, RWE and HTA/HEOR were used to search PubMed and the ISPOR Presentations Database with no date or language restrictions on 3 June 2025. Methodological guides for French, German, Italian, Spanish, and UK HTA were also retrieved. Articles were assessed according to pre-defined inclusion criteria to identify policy or methodological guidance documents, or systematic literature reviews, discussing the combined topics of HTA/HEOR, health equity and RWE.
RESULTS: Nine articles plus the NICE HTA manual health inequalities update were relevant for inclusion. Key findings: 1. RWE is an important source of data to identify and assess populations with health inequities in HTA; 2. RWE sources have a number of limitations; there is a need for best practice guidance for how to integrate RWE, health equity and HTA; 3. Measures and methodologies such as quality-adjusted life expectancy (QALE) and distributional cost-effectiveness analysis (DCEA) can use RWE to incorporate health equity analysis into HTA; 4. RWE is particularly important to address health inequalities in rare diseases, including in HTA assessments of cell and gene therapies. NICE is the only HTA agency of the scope countries which provides guidance on how RWE can be used to provide data on health inequalities for inclusion in HTA evaluations. Other HTA agencies consider RWE and/or health equity in decision-making; however, the concepts are not linked in current methodological guidance.
CONCLUSIONS: The use of RWE and the incorporation of health equity considerations into HTA is an evolving area. Increasing acceptance of RWE by HTA agencies provides more evidence to decision makers to make informed decisions, which in turn can aid health equity.