OBJECTIVES: The COVID-19 pandemic has had a tremendous impact on healthcare systems, economies, and many aspects of everyday life. The core objectives of this research were to assess the impact that the pandemic has had on HTA assessments in Europe, outline key issues faced by payers, and determine payers’ outlook on future implications.

METHODS: A qualitative, web-based survey was fielded via the Rapid Payer Response^TM online portal (RPR^®) to 15 current payers with experience in market access and reimbursement from the UK (NICE, NHS, CCG), Germany (G-BA, KV), France (CNEDiMTS, CT), Italy (AIFA, regional), and Spain (AEMPS, CIPM, MSSSI/MoH).

RESULTS: 9/15 (60%) payers expressed that the pandemic resulted in delays in HTA assessments, with an average delay of 6 to 12 months. German payers did not experience delays, noting that timelines are regulated by law. Delays in the other countries resulted in fewer completed HTA assessments per year compared to pre-pandemic years for 7/15 (47%) payers, with 6/15 (40%) feeling that access to medicines during the pandemic was impacted. Key challenges expressed by payers included clinical trial delays, de-prioritisation of non-COVID diagnoses or care, tighter healthcare budgets, and lack of staff due to COVID-related leave or re-allocations. 7/15 (47%) payers have already experienced or anticipate a quick return to pre-pandemic conditions, whereas the other 8/15 (53%) expect long-lasting effects on HTA and access in the coming years. Payers noted that pharmaceutical manufacturers could better support the HTA process by increasing preparedness and transparency, prioritising agents for review, and meeting more rigorous clinical trial design and evidence expectations.

CONCLUSIONS: Payers across all scope countries except Germany conveyed that the COVID-19 pandemic has had a significant impact on HTA assessments, which may have longer-lasting implications. Close collaboration and alignment between pharmaceutical manufacturers and HTA bodies may allow for a more efficient recovery.