OBJECTIVES : To compare how Health Technology Assessment (HTA) programs in the United States (US) and several European countries (Sweden, the United Kingdom (UK), France, Germany, Poland and Spain) currently consider the patient perspective in healthcare decision making.

METHODS : We systematically reviewed bibliographic databases and grey literature to identify the patient’s involvement and impact on HTA programs in the countries of interest. Screening and selection of articles relevant to the research questions was done by one reviewer and eligible studies were included for data extraction.

RESULTS : Procedures to acknowledge the importance of listening to the patient’s voice have been implemented in several countries. The UK has the most structured and transparent mechanisms. In Sweden, France, Poland and Germany, patient groups usually play a consultative role (e.g., submit written reports and/or attend meetings). In Spain, patients have not been involved in any HTA process. In the US, increasing concerns about value and healthcare costs are driving patient-centered research initiatives and patients’ roles are evolving within government and private HTA entities. The influence that patients have on the HTA decision-making process seems limited in most countries, but concrete examples of such influence have been found in the UK and France. In many cases, no mechanism is in place for measuring the impact of patient involvement on the decisions.

CONCLUSIONS : In many countries, patient organizations have opportunities to attend meetings and/or submit written statements to provide patient perspectives on health technologies. However, based on information available in the literature, confidentiality issues and the lack of voting rights, funding to support advocacy group efforts, and transparency regarding the content of discussions during the HTA meetings make it currently difficult for patients to influence HTA decisions. Further research is needed to explore stakeholders’ perception and experience on this topic.