A SEVEN-PILLAR HTA MATURITY SCORECARD FOR INSTITUTIONAL SELF-DIAGNOSIS: DEVELOPMENT AND APPLICATION IN CENTRAL AND EASTERN EUROPE AND MIDDLE-INCOME COUNTRIES
Author(s)
Geetika Sharma, MS1, Monica Verma, MPH2, Diego Ossa, MSc, MD3, Anand Jha, MBA4, Federico Manevy, MSc5, Noman Paracha, MSc, MBA6.
1Ansea Consultants Pte Ltd, Pune, India, 2Associate Director, Ansea Consultants Pte Ltd, Singapore, Singapore, 3Ansea Consultants Pte Ltd, Basel Stadt, Switzerland, 4Ansea Consultants Pte Ltd, Singapore, Singapore, 5Bayer Consumer Care AG, Basel, Switzerland, 6Bayer, Basel, Switzerland.
1Ansea Consultants Pte Ltd, Pune, India, 2Associate Director, Ansea Consultants Pte Ltd, Singapore, Singapore, 3Ansea Consultants Pte Ltd, Basel Stadt, Switzerland, 4Ansea Consultants Pte Ltd, Singapore, Singapore, 5Bayer Consumer Care AG, Basel, Switzerland, 6Bayer, Basel, Switzerland.
OBJECTIVES: Health Technology Assessment (HTA) systems across Central and Eastern Europe (CEE) and middle-income countries (MICs) are typically evaluated qualitatively, leaving policymakers without a systematic self-diagnosis tool. As the EU Joint Clinical Assessment (JCA) generates multinational clinical evidence, domestic capacity to act on it becomes critical. This study presents the development and CEE-focused application of a seven-pillar HTA Maturity Scorecard—a diagnostic instrument to identify institutional gaps and prioritize reform.
METHODS: The scorecard was developed through three stages: (1) literature synthesis across WHO, ISPOR/HTAi, and World Bank guidance to define seven institutional domains—legal mandate, governance, methodological guidance, capacity building, data infrastructure, stakeholder engagement, and budget/reimbursement integration; (2) derivation of readiness indicators per domain scored against a rubric assessing presence, functionality, and policy linkage to assign maturity tiers; and (3) application to CEE primary cases (Romania, Poland) benchmarked against LATAM, MENA, and APAC comparators. Countries were classified as established, emerging, and nascent.
RESULTS: Across all cases, the scorecard identified recurrent patterns, with weakness in one pillar systematically limiting the others. Romania and Poland illustrated contrasting CEE trajectories: Romania demonstrated the cost of decoupling HTA outcomes from reimbursement—formal processes since 2014, yet medicines waited 2+ years for funding—while Poland showed mandate and integration were necessary but insufficient without sustained capacity investment. Weaknesses in legal mandate, governance, and reimbursement linkage were consistently associated with limited policy impact, emerging as the primary gatekeepers regardless of technical capacity. As EU JCA outputs become available, countries scoring poorly on these three domains face the greatest readiness gap.
CONCLUSIONS: The HTA Maturity Scorecard offers CEE and MIC policymakers a transferable tool to independently identify and prioritize reform targets. Findings reveal that governance architecture—not analytical sophistication—is the binding constraint, with implications for how EU JCA can strengthen rather than bypass domestic HTA capacity.
METHODS: The scorecard was developed through three stages: (1) literature synthesis across WHO, ISPOR/HTAi, and World Bank guidance to define seven institutional domains—legal mandate, governance, methodological guidance, capacity building, data infrastructure, stakeholder engagement, and budget/reimbursement integration; (2) derivation of readiness indicators per domain scored against a rubric assessing presence, functionality, and policy linkage to assign maturity tiers; and (3) application to CEE primary cases (Romania, Poland) benchmarked against LATAM, MENA, and APAC comparators. Countries were classified as established, emerging, and nascent.
RESULTS: Across all cases, the scorecard identified recurrent patterns, with weakness in one pillar systematically limiting the others. Romania and Poland illustrated contrasting CEE trajectories: Romania demonstrated the cost of decoupling HTA outcomes from reimbursement—formal processes since 2014, yet medicines waited 2+ years for funding—while Poland showed mandate and integration were necessary but insufficient without sustained capacity investment. Weaknesses in legal mandate, governance, and reimbursement linkage were consistently associated with limited policy impact, emerging as the primary gatekeepers regardless of technical capacity. As EU JCA outputs become available, countries scoring poorly on these three domains face the greatest readiness gap.
CONCLUSIONS: The HTA Maturity Scorecard offers CEE and MIC policymakers a transferable tool to independently identify and prioritize reform targets. Findings reveal that governance architecture—not analytical sophistication—is the binding constraint, with implications for how EU JCA can strengthen rather than bypass domestic HTA capacity.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA123
Topic
Health Technology Assessment, Organizational Practices
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure
Disease
No Additional Disease & Conditions/Specialized Treatment Areas