Presentation (CTI)

OBJECTIVES: Patient input is increasingly recognized as an important aspect of HTA that helps ensure that patient perspectives are represented in the decision-making process. In Australia, comments from patients/carers have been considered by the Pharmaceutical Benefits Advisory Committee (PBAC) since 2014; in Singapore, the Agency for Care Effectiveness (ACE) has invited patients/carers to share their lived experiences to inform HTAs since 2022. To understand key patient preferences and concerns, we investigated the themes of patient/carer input in recent HTAs reported by these bodies.
METHODS: ACE technology guidance documents published in 2023-March 2025, and the 50 most recent PBAC public summary documents (PSDs) as of March 2025, were identified. Indication reviews, withdrawn appraisals and documents not reporting committee discussion were excluded. Included appraisals were reviewed for patient/carer input, and key themes/topics were identified.
RESULTS: Of the 97 appraisals reviewed, patient/carer input was reported in 61.7% and 86.0% of ACE appraisals and PBAC PSDs, respectively. Most ACE appraisals with patient/carer input discussed preferences for a new treatment (89.7%), disease burden (89.7%) and experience with current care (82.8%). Experience/expectations with the proposed intervention were reported in 41.4% of ACE appraisals. PBAC PSDs with patient/carer input most frequently discussed experience/expectations with the proposed intervention (74.4%), disease burden (65.1%) and preferences for a new treatment (60.5%); experience with current care (25.6%) was less commonly reported compared to ACE appraisals. Affordability concerns were often raised. Patients expressed that any new treatment should be affordable in 82.8% of ACE appraisals; 39.5% of PBAC PSDs noted patient affordability concerns in the absence of subsidies for the proposed intervention.
CONCLUSIONS: Patient input is commonly considered by ACE and PBAC, with key themes including disease burden, experience with current care, and expectations for new treatments. Affordable access to effective treatment was often identified as an important patient concern.