OBJECTIVES: To explore the potential for ‘living’ health technology assessments (HTA) by using examples from successful living guidelines.

METHODS: The Australian Living Evidence Consortium (ALEC) hosts several living guidelines including: the Australian Guidelines for the Clinical Care of People with COVID-19, Australian Clinical Guidelines for Stroke Management, Australian Evidence-Based Clinical Guidelines for Diabetes, An Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis, and Caring for Australian and New Zealanders with Kidney Impairment (CARI) Guidelines. ALEC has also recently produced a methods guidance on how to develop living guidelines. We used examples from these successful living clinical practice guidelines, focusing particularly on pharmaceutical treatments, to describe opportunities for living HTA.

RESULTS: Using illustrative examples from our living guidelines experience we explore potential implications of the living approach for drug pricing decisions, the effects of variations in uncertainty over time as new evidence emerges, timing of patient access to treatments, and potential impacts on the healthcare system. We describe the synergies between living guidelines and the HTA process, such as searching, collaboration, systematic review methods, and adoption of screening, publication platforms, and automation software. Reflecting on how these have been successfully applied in living guidelines, we provide a framework of how they could be utilised in living HTA. We highlight the key differences for living guidelines compared to the HTA process, including cost-effectiveness analysis, financial impact analyses, registry data, highly specialised technologies and single-arm studies, post-market surveillance, and utilisation data.

CONCLUSIONS: HTA processes could benefit from the methods and practical experiences from successful living guidelines and living systematic reviews to adopt a living approach to HTAs. Further piloting of living HTAs is needed to inform how living methods can apply in practice.