OBJECTIVES: Health technology assessments (HTAs) are being progressively used on a global scale to evaluate the economic impact of reimbursing technologies. Typically, cardiovascular interventions represent a large share of healthcare payer costs due to ageing populations. Despite increased pressure on healthcare budgets, cross-country differences exist pertaining the required evidence by HTA agencies, and the implications of HTA on reimbursement. In this study we assess evidential requirements for HTA, and its subsequent impact on the reimbursement of cardiovascular interventions in 5 countries in Asia-Pacific.

METHODS: Data was obtained from IQVIA HTA Accelerator and national HTA assessment bodies. HTA Accelerator includes 28,514 HTA appraisals from ≥100 HTA agencies in 39 countries. The database was searched to obtain cardiovascular appraisals 2019 for Japan, Singapore, South Korea, Taiwan, and Thailand.

RESULTS: In total 15 cardiovascular submissions were identified. Cost-effectiveness analysis (CEA) were observed in Japan and Singapore. Budget impact analysis (BIAs) were considered as key evidence in Taiwan and Singapore. In South Korea economic analysis was not performed. No submissions for Thailand were found. All economic analysis relied on pivotal clinical data ranging from head-to-head trials to indirect comparisons. South-Korea focused on evaluating procedures while other countries assessed medicines and devices.

CONCLUSIONS: Heterogeneity of the information considered to inform healthcare decision making exists in Asia-Pacific. For Taiwan, an emphasis is placed on the financial impact (BIA) while the value-for-money (CEA) tends to be a key driver for decisions in Japan; Singapore considers both whilst South Korea only reports scientific evidence. Other regions with HTA, such as Europe, both the CEA and BIM are typically taken into account. Differences across Asia-Pacific alongside the recent implementation of HTA in Japan demonstrates further changes should be anticipated in HTA over coming years within the Asia-Pacific region.