OBJECTIVES: To improve the methods and process of future HTA processes in China, a large national survey was conducted to gather experts' views on three key issues related to HTA: the willingness-to-pay (WTP) threshold for one additional unit of quality-adjusted life year (QALY), principles for choosing comparator(s) for economic evaluation, and the price model for multi-indication drugs.

METHODS: A questionnaire was developed based on feedback collected from workshops and the results of literature reviews. On 10/03/2023, a generic invitation with a web link to the questionnaire was disseminated to relevant stakeholders with knowledge of HTA in China. A snowball sampling technique was used to recruit participants. The data were analyzed using framework analysis with the incidence density method. Furthermore, the relationship between the participants' responses and their demographic characteristics was explored using a logistic model, generalized ordered logit model or multinomial logit model depending on the type of responses.

RESULTS: By 01/06/2023, 303 responses were received. The responders’ backgrounds included academia (41.58%), private sector (40.59%), and government or public sector (17.82%). The WTP threshold most commonly chosen by responders was 1-2 times GDP (39.60%), followed by ≤1 time GDP (32.67%) and 2-3 times GDP (20.79%). 60.39% of responders believed that single pricing is the most appropriate price model for multi-indication drugs in China. 56.76% responders believed that the comparator for a patent medicine launched to the market less than three years ago should also be a patent medicine.

CONCLUSIONS: To our knowledge, this study is one of the first efforts internationally to use the survey method to formally gather stakeholders' views on the HTA process. The findings of our study may play a critical role in shaping the future HTA process in China and are likely to have a far-reaching impact on the access to drugs for the 1.4 billion Chinese population.