Striking a balance between accuracy and timeliness in HTA: an elusive task
Abstract Issue HTA is a decision-making tool. Users need high-quality and timely evidence to ensure sound resource allocation and timely access to innovation. High-quality HTA recommendations are time-consuming to generate, requiring high-quality evidence and timely evidence synthesis, as well as mechanisms to ensure timely recommendation release and feasible implementation of guidance. Description of the problem HTA submissions, issuing recommendations and implementation guidance oftentimes have no transparent timelines, with high accuracy posing unique challenges for timeliness. We can broadly examine such challenges in the context of methodologies and processes. Accuracy ensures longer-term validity of decision-making, however, HTA should not be used only for new technologies but also revision of previous decisions through timely re-assessment, ensuring obsolete technology disinvestment. Effects/changes Through the exploration of models and tools previously implemented across jurisdictions and settings, such as early-warning systems, conditional approvals and horizon scanning, it will be demonstrated that well-defined prioritisation criteria accepted by both doers and users, adequate capacity and sound preparation of stakeholders are all key elements to ensure the highest possible degree of timeliness and accuracy, and to strike a balance between the two. Particular attention will be paid to critical challenges for public health access and delivery, i.e., emerging technologies and complex interventions, highlighting how horizon scanning ought to start at the discovery, rather than development phase and transparency challenges. Technology tracking and mechanisms for standardizing methodologies and processes will also be discussed. Lessons Monitoring and evaluating the impact of HTA methodologies and processes in a transparent manner needs to become an inherent part of HTA to ensure existing and future challenges of accuracy and timeliness can be adequately addressed.
