Presentation (CTI)

OBJECTIVES: Explore the application of patient-reported outcomes (PROs) and patient and public involvement (PPI) to national health technology assessment (HTA) in America, England, China, and Brazil.
METHODS: A targeted review was conducted across multiple HTA agency web portals, including the Institute for Clinical and Economic Review (ICER), National Institute for Health and Care Excellence (NICE), Center for Drug Evaluation (CDE), and National Committee for Technology Incorporation (CONITEC), to extract information on the role of PROs and PPI in the submission process. Extracted data were synthesised to identify common practices and variations across agencies. The findings were then analysed to identify leaders, followers, and laggards in the adoption of PRO measures and PPI within HTA frameworks.
RESULTS: The findings from this research demonstrated that ICER and NICE are leaders, with transparent and systematic approaches for including PPI and PROs throughout HTA (e.g. pre-submission, during HTA, and post-submission). CONITEC was identified as a follower, demonstrating PPI including attending public meetings and patient input on draft proceedings. Factors such as transparency, expansion of communication, and strengthening patient confidence to engage would be needed to support more meaningful PPI and move Brazil to a leader status. Despite PRO inclusion by the CDE, PPI was limited, with interests often represented by health policy-makers or healthcare institutions. As such, CDE was identified as a laggard, with direct HTA patient participation needed to improve PPI.
CONCLUSIONS: The level of PRO measures and PPI in HTA varied across agencies, with ICER and NICE as leaders, CONITEC as a follower, and CDE as a laggard. Although currently limited in some markets, PRO and PPI are likely to play a greater role in future HTA as greater emphasis is placed on patient autonomy and voice.