scholarly journals Description of the use of Multicriteria to Support Pricing and Reimbursement Decisions by European Health Technology Assessment Bodies.

Author(s):  
David Elvira ◽  
Mercè Obach ◽  
Caridad Pontes

Abstract BackgroundHeterogeneity in drug access throughout Europe may be influenced by differences in drug-assessment strategies. The EUnetHTA’s assessment core model (EUnetHTA-core) and the EVIDEM’s multicriteria framework are reference methodologies in this context, the latter including a wider compromise between non-contextual and contextual criteria. Compliance of 37 European Health Technology Assessment bodies (HTAb) with EUnetHTA-core has been reported, but the use of EVIDEM by this HTAb is still unknown.ObjectiveTo describe the uptake and use of multicriteria approaches to evaluate drug value by European HTAb using EVIDEM as reference framework. MethodsMulticriteria framework was obtained based on EVIDEM model. The criteria used for drug appraisal by HTAb was extracted from the EUnetHTA report, and completed through search of websites, publications and HTAb reports. Use of EVIDEM assessment model in 37 European HTAb has been described semi-quantitatively and summarized using an alignment heatmap.ResultsAligned, medium or misaligned profiles were seen for 24,3%, 51,4% and 24,3% of HTAb when matching to EVIDEM dimensions and criteria was considered. HTAb with explicit responsibilities in providing specific advice on reimbursement showed more aligned profiles on contextual and non-contextual dimensions. ConclusionsMost of the 37 European HTAb have room to broaden their contextual assessment tools, especially when social and medical perception of need requires to be explicit to support payer’s decision on reimbursement.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Elvira ◽  
Mercè Obach ◽  
Caridad Pontes

Abstract Background Heterogeneity in drug access throughout Europe may be influenced by differences in drug-assessment strategies. The EUnetHTA’s assessment core model (EUnetHTA-core) and the EVIDEM’s multicriteria framework are reference methodologies in this context, the latter including a wider compromise between non-contextual and contextual criteria. Compliance of 37 European Health Technology Assessment bodies (HTAb) with EUnetHTA-core has been reported, but the use of EVIDEM by this HTAb is still unknown. Methods To describe the uptake and use of multicriteria approaches to evaluate drug value by European HTAb using EVIDEM as reference framework, a multicriteria framework was obtained based on EVIDEM model. The criteria used for drug appraisal by HTAb was extracted from the EUnetHTA report, and completed through search of websites, publications and HTAb reports. Use of EVIDEM assessment model in 37 European HTAb has been described semi-quantitatively and summarized using an alignment heatmap. Results Aligned, medium or misaligned profiles were seen for 24,3%, 51,4% and 24,3% of HTAb when matching to EVIDEM dimensions and criteria was considered. HTAb with explicit responsibilities in providing specific advice on reimbursement showed more aligned profiles on contextual and non-contextual dimensions. Conclusions EUnetHTA’s core model is limited in assessing medicines while EVIDEM’s framework provides contextual dimension used by some HTAb in Europe that can be escalated to other agencies. Most of the 37 European HTAb have room to broaden their contextual assessment tools, especially when social and medical perception of need requires to be explicit to support payer’s decision on reimbursement.


2018 ◽  
Vol 10 (12) ◽  
pp. 4748 ◽  
Author(s):  
Francesca Iandolo ◽  
Pietro Vito ◽  
Irene Fulco ◽  
Francesca Loia

This paper aims to propose a methodological lens to the assessment of technological innovations in healthcare based on the principles of social, economic, and political sustainability. Starting from the consideration of a lack of a unified interpretative framework of health technology assessment, using a content analysis of the relevant literature on the topic, we identified both the scientific perspectives adopted by the scholars and the most widely discussed topics. Consequently, the less explored scientific areas were framed, and, therefore, those more susceptible to further investigation came to light. The result is an overall picture which highlights the absence of unified and generally accepted approaches to evaluation, together with the lack of awareness on the fact that the multiplicity of methods adopted is essentially connected to the multiplicity of innovations, for each of which a method (or a set of methods) of preferable evaluation can be prefigured. Based on these observations, we propose a general reference framework for evaluation, based on the Viable Systems Approach (vSa), and a schematic outline of the connections between the complexity of innovations and the evaluation methodologies.


2017 ◽  
Vol 33 (3) ◽  
pp. 365-370 ◽  
Author(s):  
Tatyana Benisheva-Dimitrova ◽  
Dobriana Sidjimova ◽  
Daniela Cherneva ◽  
Nikolay Kralimarkov

Objectives: The aim of this study was to investigate the analysis, discussion, and challenges of the price and reimbursement process of medicinal products in Bulgaria in the period 2000–15 and health technology assessment (HTA) role in these processes.Methods: The dynamics of the reform, with respect to the healthcare and pharmaceutical sectors, are tracked by documentary review of regulations, articles, and reports in the European Union (EU), as well as analytical and historical analysis.Results: Pricing and reimbursement processes have passed through a variety of committees between 2003 and 2012. Separate units for pricing and reimbursement of medicinal products were established in Bulgaria for the first time, in 2013, when an independent body, the National Council at Prices and Reimbursement of Medicinal Products, was set up to approve medicinal products with new international nonproprietary names (INN) for reimbursement in Bulgaria. Over the course of 2 years (2013–14), thirty-three new INNs were approved for reimbursement. In December 2015, a new HTA body was introduced, and assigned to the National Centre for Public Health and Analyses.Conclusions: Although Bulgaria has current legislation on pricing and reimbursement which is in accordance with the EU rules, there is no mechanism for reporting and monitoring these processes or the financial resources annually, so as to provide an overall objective assessment and analysis by year. Therefore, this financial assessment should become a national policy objective for the future.


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