OBJECTIVES : To investigate the impact of the COVID-19 pandemic on the drug technology assessment (TA) process of European HTA agencies. This study explored changes to routine practice and assessment in response to the pandemic, and assessed the impact of these changes on the number and type of assessments published during this time.

METHODS : Adaptations to current assessment practices were established for each HTA agency, including timelines where available. TAs published by the National Institute for Health and Care Excellence (NICE), Scottish Medicines Consortium (SMC), Haute Autorité de Santé (HAS) and Gemeinsame Bundesausschuss (G-BA) during the last 2 years were identified and compared.

RESULTS : Initial meeting suspension resulted in the absence of SMC assessments between May and July 2020, with a subsequent phased approach including scope for ‘fast-track to advice’. As part of the phased approach, medicines with the potential to deliver the greatest benefit to patients were prioritised for assessment, although the number of cancer-related assessments remained consistent. NICE published only one assessment per month in March and April 2020, with minimal notable impact on the number of subsequent assessments. Work related to addressing COVID-19 diagnostic or therapeutic interventions and medicines deemed ‘therapeutically critical’ was prioritised, and a higher proportion of assessments pertaining to cancer were published following the emergence of COVID-19. HAS initially assigned priority to drugs intended to manage COVID-19 in addition to new TAs or extension of indication assessments in oncology, paediatrics and in serious illnesses with an unmet medical need; the number of oncology assessments remained consistent following COVID-19 emergence. The reported impact on Germany was minimal; G-BA meetings were held virtually to minimise delays in assessments or pricing negotiations.

CONCLUSIONS : Despite the individualised approach in response to the challenges of COVID-19, European HTA agencies demonstrated minimal long-term impact and a return to normal drug TA output.