PURPOSE: Economic evaluation is an important tool to inform health care resource allocation worldwide, and HTA agencies typically develop methods guidance which, in part, sets out expectations on how the economic evidence is developed and appraised. Determining such guidance is, however, never without controversy. This workshop aims to reflect on the experiences of HTA agencies in different jurisdictions in Europe that have recently, or are currently, updating their methods guidance -- EUnetHTA, INFARMED for Portugal and NICE for England -- to identify the most pressing methods and normative issues associated with the updated guidance and main areas of controversy.

DESCRIPTION: The workshop will start with an introduction to the topic (Mark Sculpher, 7 minutes). The panellists will then identify challenging aspects of three recent methods guidance updates, describing changes implemented. The three guideline updates are:

. the Portuguese guidelines (Marta Soares, 12 minutes) that changed recommendations on the perspective of analysis and explicitly defined principles for re-appraisal and further evidence requests, amongst others;

. the EUnetHTA guidelines (Conor Teljeur, 12 minutes) that identifies problems with the selection of comparators when not working on the efficiency frontier and considers issues with the use of surrogate outcomes, amongst others; and

. the ongoing review of the NICE methods guide (Ian Watson, 12 minutes), which is considering a wide range of topics, including exploration of uncertainty, factors and evidence considered in decision-making, issues for emerging technologies, and others.

The panellists will reflect on the motivations, and controversies, associated with each topic area, drawing from the comments received from stakeholders (e.g. at public consultation), where available. The reflections made will consider who the guidelines are for, the process for identifying and formulating updates/revisions, and the process whereby stakeholders can input into the changes.

The workshop will end with a structured interactive discussion (Mark Sculpher, 17 minutes).