OBJECTIVES: Traditional HTA approaches have proven to be unsuitable for several drugs (particularly in Oncology), as cost-effectiveness analysis does not account for all value dimensions, for instance: the higher benefit of drugs in early indications or even the overall social benefit of the drug. HTA reshaping has the main objective of fostering the discussion around the evaluation of health technologies, aiming at defining a more appropriate framework to accommodate the innovation to come.

METHODS: HTA reshaping is an initiative that aims to start the discussion on the current HTA framework and collecting inputs from all relevant stakeholders. The project is carried out in three sequential phases:

First, Portugal’s HTA methodology was analyzed and compared with European approaches. Then, new frameworks were mapped and evaluated, identifying best-practices and variables to account for in the new framework. Through in-depth interviews the outlook of the new approach was drafted. Two subsequent workshops were held with the main objective to discuss these findings and propose a new HTA framework.

RESULTS: The discussion was centered around the ten parameters that are the foundations of the HTA approach: comparator, population, therapeutic assessment, timeframe, methods, perspective, cost-effectiveness, prices, PROs and budget impact. The future challenges (such as combination drugs, payment by usage and low evidence) were also accounted for and included in the recommendations for the proposed Portuguese HTA framework.

CONCLUSIONS: The evaluation of Health Technologies is a critical tool that aims to enable patient access to innovation without jeopardizing NHS sustainability. However, Health is an ever-evolving sector, and if the growing development of innovative and more specific drugs brings unquestionable benefits to patients, it often comes with a high price tag. HTA frameworks need to evolve, to be prepared to face the upcoming challenges and to adapt to the growing demands of our Society.