Principal Investigator: Panos Kanavos
Start Date: 01 January 2013
End Date: 31 December 2015
Region: Europe, Americas
Keywords: health technology assessment, rare diseases, medical devices, value for money, burden of disease, disease severity, capacity building of HTA, value assessment, efficiency in resource allocation, health technology regulation & assessment
ADVANCE-HTA was a research project funded by the European Commission's Research Framework Programme (FP7). It comprised several complementary streams of research that aimed to advance and strengthen the methodological tools and practices relating to the application and implementation of Health Technology Assessment (HTA). It was a partnership of 13 Consortium members led by LSE Health.
Advance-HTA had as its fundamental objective, the methodological advancement of HTA across a range of settings in Europe, North and Latin America, among others. This was achieved by involving the wider stakeholder community in the debate surrounding decision-making and resource allocation. In order to achieve this, several complementary streams of research were carried out that addressed:
- Issues around value for money and the different approaches surrounding current thresholds for decision-making and resource allocation
- The concept of value assessment, and the factors that need to be considered beyond clinical cost effectiveness
- The quality of the evidence required for and the methods associated with the assessment of rare diseases
- Furthering the debate surrounding the elicitation of preferences by deriving these in more realistic settings within the patient community
- The debate on the suitability of current HTA tools across different categories of medical devices (e.g. diagnostics)
- Improving the implementation and capacity building of HTA including beyond Europe, especially where HTA is considered explicitly in decision-making
In undertaking these activities, ADVANCE-HTA aimed to broaden the spectrum, complement and address areas of intense methodological debate in the application, use and implementation of HTA across settings. It also aimed to improve HTA methods, which can be taken further by competent authorities nationally whilst supplementing the work of supra-national bodies (e.g. EUnetHTA) towards a common understanding of choices in health care decision-making.
The Advance-HTA project’s findings offer European decision makers a wide range of useful insights into how in future cost effectiveness evaluations of not only medicines but products such as medical devices (and perhaps in time interventions such as surgical operations) could be better conducted. They also raise important questions as to the extent to which in contexts like promoting enhanced outcomes in areas of cancer care and the treatment of rare monogenic diseases the criteria used for evaluating the ‘worth’ of therapeutic innovations might be standardised across the European Union, and how regionally or globally consistent approaches to adjusting for factors like GDP and disease prevalence variations could be instituted.
Technically, Advance-HTA’s results raise questions about how the affordability thresholds used in assessments can best be set, and the degree to which the extended use of MCDA techniques would materially enhance the validity and acceptability of currently established evaluation methods. They also highlight as yet unresolved uncertainties about the extent to which national policy decisions or individual treatment choices could ever be determined on the basis of HTA findings alone.
To read more about the project's findings and outcomes, see here.