OBJECTIVES

: This analysis evaluated the importance and impact of patient perspectives in value assessments by HTA bodies from two dimensions: stated importance and actual impact.

METHODS

: Stated Importance (SI) assesses the HTA body’s perspectives on importance of patient-centric data in value assessment. Based on published guidance by leading institutions, seven domains were identified as good practices for collecting patient input in value assessments. SI of each HTA was evaluated against identified good practices on a 0-1 scale (0=none and 1=all good practices followed). Actual Impact (AI) assesses whether relevant patient-reported outcomes (PROs) are considered in the value assessment by HTA bodies. To measure AI, recent appraisals by HTAs on selected biologics for the treatment of psoriasis were analyzed as an example. Five PRO domains were identified as important evidence of patient benefits. AI of these domains on value assessment by each HTA body was evaluated on a 0-1 scale based on how many domains were considered in the assessment (0=None and 1=All domains considered).

RESULTS

: SI varied across agencies with high to low scores as follows: IQWiG (Germany) and NICE (UK) 0.86, CADTH (Canada) 0.71, PBAC (Australia) and HIRA (South Korea) 0.43, HAS (France) 0.29. Scores for AI were as follows: IQWiG 0.80, CADTH and HAS 0.60, HIRA and NICE 0.40, PBAC 0.20. The most prominent gaps in patient input by HTAs were in the domains of diversity, transparency, and timeliness. The most common PRO domain not evaluated was work productivity.

CONCLUSIONS

: IQWiG yielded the highest combined score across stated importance and actual impact of patient-centric data. The observed variations and gaps between HTAs emphasize a clear need for standardized patient-focused value assessment best practices across HTAs. Lack of transparency on HTAs’ decision drivers limits our ability to establish correlation between considerations of PRO evidence and final decision making.