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Navigating change: a comparative analysis of health technology assessment reforms across agencies - processes, drivers, and interdependencies
Journal article   Open access   Peer reviewed

Navigating change: a comparative analysis of health technology assessment reforms across agencies - processes, drivers, and interdependencies

Gayathri Kumar, Priscila Radu, Patricia Cubi-Molla, Martina Garau, Eleanor Bell, Jia Pan, Ramiro Gilardino, Julie Van Bavel, Agnes Brandtmuller, Katherine Nelson, …
International journal of technology assessment in health care, v 41(1), 21
14 Mar 2025
PMID: 40083319
url
https://doi.org/10.1017/S0266462325000133View
Published, Version of Record (VoR) Open

Abstract

Health Care Sciences & Services Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology Medical Informatics
Objectives Health technology assessment (HTA) is a critical part of healthcare decision making in many countries. Changes in Methods and Processes (M&P) of HTA agencies can affect the time and degree of patient access to treatments. Published literature focuses on the different M&P adopted by HTA agencies, rather than on how these have come about over time. Our study investigates key HTA reforms and explores their drivers and interdependencies in a set of HTA agencies in Europe, Asia-Pacific, and North America.Methods We conducted a targeted literature review on M&P guidelines and subsequent changes to those, for 14 HTA agencies. We supplemented and validated initial findings with 29 semi-structured interviews with country-specific experts. We used analytical tools to create process maps, proactivity and influence networks, and clusters of HTA agencies.Results We found that processes leading to M&P reforms follow similar steps across HTA agencies. The three most important drivers to reforms were HTA practice and guidelines in other countries; the healthcare policy, legal, and political context within the agency's country; and experience of challenges in the assessment by the HTA body itself. International collaborations have the potential to accelerate the evolution of HTA systems and the implementation of reforms.Conclusion We identified PBAC (Australia), CDA-AMC (Canada), NICE (England), IQWiG (Germany), and ZIN (the Netherlands) as HTA agencies that are catalysts of HTA reforms as well as internationally influential. International collaborations may represent a useful route to accelerate changes as long as they ensure wide stakeholder engagement at an early stage.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Health Care Sciences & Services
Medical Informatics
Public, Environmental & Occupational Health
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