OBJECTIVES

The aim of this study is to analyze current patient involvement in health technology assessments (HTAs) in the European, US and Canadian HTA agencies.

METHODS

A systematic literature review of articles, published in English between 2016 and 2021 on HTA and patient engagement, has been conducted.

RESULTS

A total of 19 articles out of 45, identified through a systematic literature review, were included. It was found that two key sets of reasons for involving patients in HTAs are generally cited in the literature: 1) transparency, legitimacy, and fairness in decision-making and, 2) patients’ evidentiary contributions, as they have first-hand experiential knowledge. There are two different and complementary ways for patient involvement in HTAs: through consultation and/or collaboration. Although patient engagement in HTAs is growing, there is substantial variety in the level of patient engagement across the HTA agencies. Some agencies have well-established patient roles in their HTA processes. Examples of those are CADTH in Canada, in which patients have voting rights, and NICE in the UK and SMC in Scotland in which patients provide submissions to the agency and participate in committee meetings. In the US, patient engagement in HTAs has improved considerably in the last few years; however, it has not yet been well implemented. Patient engagement in HTAs has been reported to have several issues, the methodological issues being the most common ones (82%).

CONCLUSIONS

The level of patient involvement in HTA agencies across the world is heterogenous and unclear. The integration of patient preferences in HTAs is expected to contribute to better decision making and to increase uptake, adherence, and patient satisfaction. However, there are some methodological and procedure issues. Moreover, the large number of different issues advocates the overall importance of a multi-stakeholder and holistic approach to the integration of patient preferences in HTAs.