International Journal of Technology Assessment in Health Care最新文献

{"title":"Beyond stage-appropriate evaluation: can current choices constrain downstream options?","authors":"Bjoern Schwander","doi":"10.1017/S0266462326104206","DOIUrl":"https://doi.org/10.1017/S0266462326104206","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e85"},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holding up the mirror: how can HTA achieve more transparent, equitable, and fair health systems?","authors":"Clifford Goodman, Iga Lipska, Karen Alparce-Villanueva, Emilia Caro, Adolfo Rubinstein, Virginie Giroux, Antonio Migliore","doi":"10.1017/S0266462326104152","DOIUrl":"https://doi.org/10.1017/S0266462326104152","url":null,"abstract":"<p><p>Health technology assessment (HTA) has advanced rigorous, transparent methods for informing resource allocation; however, persistent inequities, declining trust, and rapidly evolving technologies expose a gap between technical excellence and social justice. This perspective synthesizes Plenary Three of the HTAi 2025 Annual Meeting, which examined how HTA can contribute to more transparent, equitable, and fair health systems. Drawing on multistakeholder perspectives from patient advocacy, global health equity, health policy, industry, and HTA research, this article argues that transparency, equity, and trust must be treated as foundational principles rather than optional enhancements. It highlights persistent challenges, including opaque deliberation, context-dependent definitions of equity, limited feedback to patient contributors, and evidence bases that insufficiently reflect diverse populations. Emerging practices from leading HTA bodies illustrate practical pathways forward. The article concludes that HTA's convening power can help transform it from a technical gatekeeper into a guardian of fairer health systems across diverse contexts.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e81"},"PeriodicalIF":3.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward hybrid mental health care: an early health technology assessment based on stakeholder analysis and economic simulations - ERRATUM.","authors":"Mari Skoge, Linn Nathalie Støme, Sofie Ragnhild Aminoff, Henrik Myhre Ihler, Kari Jorunn Kværner, Josina Vink, Kristin Lie Romm","doi":"10.1017/S0266462326104188","DOIUrl":"https://doi.org/10.1017/S0266462326104188","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e80"},"PeriodicalIF":3.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference prices matter: impact on cost analyses in economic evaluations.","authors":"Thomáy-Claire A Hoelen, Ann-Sophie Nebel, Agnes T G Paulus, Silvia M A A Evers, Paul C Willems, Ghislaine A P G van Mastrigt","doi":"10.1017/S0266462326104103","DOIUrl":"https://doi.org/10.1017/S0266462326104103","url":null,"abstract":"<p><strong>Objectives: </strong>Variability in methodology and pricing across country-specific health economic evaluation (EE) guidelines hampers cross-national transferability. Guideline updates can also impede generalizability within countries over time. This study empirically illustrates how changes in reference prices impact cost analysis within (partial) EEs, using the economic burden of adolescent idiopathic scoliosis (AIS) in the Netherlands and the United Kingdom (UK).</p><p><strong>Methods: </strong>Country-specific databases were used to estimate costs to compare within- and cross-country EE guidelines. Reference prices from the Dutch (2014 and 2024) and UK (2021/2022 and 2022/2023) guidelines were considered, and resource usage was held constant. Costs were indexed (2022) and adjusted using Purchasing Power Parity. Societal cost per AIS patient, share attributions, and unit costs between EE guidelines were compared.</p><p><strong>Results: </strong>Within-country comparisons indicated societal cost increases in the Netherlands (18 percent) and the UK (1 percent). Following a Dutch guideline update, twelve cost items changed by >10 percent, compared with four did in the UK update. UK societal costs were 69 percent higher than in the Netherlands. Ten cost items differed by >100 percent, with generally higher UK costs.</p><p><strong>Conclusions: </strong>EEs cost analyses are substantially influenced by differences in reference prices across countries. National guideline updates can markedly affect the within-country comparability and generalizability of cost analyses over time. Increased transparency in methods used to derive reference prices is essential to improve transferability and interpretation of EE results. A standardized approach for estimating reference prices could reduce methodological variation, strengthen consistency across jurisdictions, and enhance comparability of international and longitudinal EEs.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e78"},"PeriodicalIF":3.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The case for updating health economic evaluation of digital technologies: in response to the demographic challenges.","authors":"Kristian Kidholm, Minna Johansson, Maja Kjær Poulsen","doi":"10.1017/S0266462326104139","DOIUrl":"10.1017/S0266462326104139","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this article is to present arguments and examples of practical tools for adjusting economic evaluations and Health Technology Assessment (HTA) to ensure that assessments of DHTs reflect current demographic challenges.</p><p><strong>Methods: </strong>The arguments are based on a narrative review of studies of the effects of DHTs on health care professionals' workload and use of time.</p><p><strong>Results: </strong>Based on the review, three recurring themes were identified: (1) the different definitions of effects on clinician time, (2) the need for quantitative assessment of effects on clinician time, and (3) the different kinds of effects on clinician time.</p><p><strong>Conclusion: </strong>On this basis, two suggestions for adjustment of economic evaluations and HTA are presented: by the collection of data and presentation of results on the effects of DHTs on Time Needed to Treat (TNT), and by the use of shadow prices to ensure that the costs of healthcare professionals are correctly reflected in the alternative costs.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e77"},"PeriodicalIF":3.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hospital-based HTA model to assess the economic and organizational impact of intravenous-to-subcutaneous monoclonal antibody transitions in oncology.","authors":"Giorgia Zorzetto, Alberto Russi, Alessandro Giuriola, Giuseppe Di Blasio, Sara Lonardi, Valentina Guarneri, Marco Maruzzo, Maria Vittoria Dieci, Giulia Pasello, Michele Gottardi, Silvia Cognolato, Nicoletta Rigamonti, Chiara Mioni, Flavio Cazzador, Giulia Badaile, Francesca Pipitone, Daniela Grosso, Patrizia Simionato, Giovanna Scroccaro, Marina Coppola","doi":"10.1017/S0266462326104000","DOIUrl":"https://doi.org/10.1017/S0266462326104000","url":null,"abstract":"<p><strong>Objectives: </strong>Subcutaneous (SC) formulations of monoclonal antibodies (mAbs) allow faster and less invasive administration than intravenous (IV) routes, with comparable efficacy and safety. Beyond clinical equivalence, SC administration may reduce hospital resource use, improve patient experience, and increase treatment capacity, contributing to the sustainability of oncology care. This study aimed to develop and apply a hospital-based, multidisciplinary model to assess the economic and organizational impact of IV-to-SC transitions in oncology.</p><p><strong>Methods: </strong>A scenario-based economic and organizational analysis was conducted using real-world institutional data from a high-volume oncology center, collected before price renegotiations, to estimate the budget impact and resource implications of transitioning from intravenous to subcutaneous mAbs. The analysis included drug acquisition, pharmacy preparation, nursing administration, chair occupancy, and staff time, with preparation costs estimated using Time-Driven Activity-Based Costing (TDABC). The model was applied to two mAbs (X and Y); eligible patients were identified through institutional registries, and scenario analyses simulated partial and complete IV-to-SC substitution across clinical settings.</p><p><strong>Results: </strong>For antibody X, a full transition to SC administration increased annual treatment capacity by ~36 percent, with an additional drug expenditure of €123,354 and an overall budget impact of €66,778. For antibody Y, full SC adoption increased treatment capacity by ~19 percent, with an additional drug expenditure of €42,473 and a total budget impact of €6,671.</p><p><strong>Conclusions: </strong>SC-related efficiency gains are highly context-dependent and are maximized in settings with latent capacity demand. The proposed hospital-based HTA framework supports evidence-based adoption strategies and informs sustainable pricing and organizational decision making in oncology.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e79"},"PeriodicalIF":3.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing mini-HTA to support evidence-based decision making in the Norwegian health services.","authors":"Helene Arentz-Hansen, Hanne Marie Rostad, Vidar Jusnes Vang, Anna Stoinska-Schneider, Maria Bjerk","doi":"10.1017/S0266462326103894","DOIUrl":"https://doi.org/10.1017/S0266462326103894","url":null,"abstract":"<p><p>Health technology assessment (HTA) has become an essential tool for supporting evidence-based decision making in health care systems worldwide. Comprehensive HTA reports, however, are resource-intensive and time-consuming, making them impractical for many decisions that need to be made at the local or institutional level. This gap has led to the development of more pragmatic approaches that aim to balance methodological rigor with feasibility. In Norway, this challenge was addressed through the introduction of mini-HTA, which is a structured, simplified, and context-specific decision-support tool to inform local or institutional decisions about introducing new technologies, procedures, or organizational innovations. Mini-HTA provides a standardized framework for evaluating clinical effectiveness, safety, organizational impact, ethical considerations, and economic consequences while remaining feasible for clinicians and managers to apply in practice. Several key insights emerge from our experience with developing and implementing mini-HTA in Norway. First, adapting HTA approaches to local decision-making contexts increases feasibility and uptake, particularly where time and resources are limited. Second, governance structures, including clear allocation of responsibilities and leadership engagement, are crucial for the consistent use of mini-HTA in practice. Third, the Norwegian experience illustrates how a shared but flexible tool can be applied across different levels of care, including both hospitals and municipalities, while still allowing for contextual adaptation. Finally, the use of mini-HTA as a platform for collaboration across sectors highlights its potential not only as a decision-support tool, but also as a mechanism for coordinating priorities and responsibilities across organizational boundaries.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e72"},"PeriodicalIF":3.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A life-cycle approach to digital health technology assessment.","authors":"Ashwini Kanakapura Sriranga, Baptiste Vasey, Mateo Campos, Miguel Ángel Armengol de la Hoz, Ruben Casado Arroyo, Stephen Gilbert, Rebecca Mathias, Lucia Osoro, Peter McCulloch","doi":"10.1017/S0266462326104097","DOIUrl":"10.1017/S0266462326104097","url":null,"abstract":"<p><p>The approach of Health Technology Assessment, which developed from the Evidence-Based Medicine movement of the 1990s, has proved its value in appraising the value of pharma products but presents methodological challenges when applied to medical devices and digital technologies, whose importance has increased enormously during the last 30 years. The concept of a single assessment, which can summarize relative effectiveness and cost-effectiveness, has been further challenged by the rapidly rising importance of software-driven devices, and latterly Artificial Intelligence. The need to adopt a broader evaluation approach based on product life cycles has been recognized by both regulators and HTA bodies, but practical frameworks for this have not yet been widely adopted. We describe a Life-Cycle-Based Evaluation (LCBE) approach to the assessment of Digital Health Technologies, developed as part of the ASSESS-DHT Horizon Europe 2020 project, EU project 101137347. The LCBE framework is currently being evaluated in pilot studies and aims to support early, proportionate, and continuous assessment and foster collaboration among developers, regulators, and HTA bodies to ensure timely, rigorous, and adaptive evaluations across the technology life cycle.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e70"},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health technology assessment in Eastern Europe and Central Asia: an updated SWOT analysis - CORRIGENDUM.","authors":"Rabia Sucu, Antonio Migliore, Nicola Vicari, Esra Meltem Koç, Alima Almadiyeva","doi":"10.1017/S0266462326103973","DOIUrl":"https://doi.org/10.1017/S0266462326103973","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e71"},"PeriodicalIF":3.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surrogate endpoints in cost-effectiveness analysis for use in health technology assessment - a qualitative analysis.","authors":"Laura Flight, Fatima Salih, Shane D Collins, Phyo Aung, Michael Coory, Daniel A Ollendorf, Marina Richardson, Zoe Garrett","doi":"10.1017/S0266462326103791","DOIUrl":"10.1017/S0266462326103791","url":null,"abstract":"<p><strong>Objectives: </strong>The use of surrogate endpoints poses challenges to health technology assessment (HTA) agencies and payers when informing the clinical and cost-effectiveness of health technologies. Decision makers often need to make recommendations in the absence of well-established evidence on their validation, particularly when the surrogate endpoint is novel without clear links to the longer-term outcome. This study explored the guidance needs of HTA agencies and identified how they have considered and dealt with surrogate endpoints in cost-effectiveness analysis.</p><p><strong>Methods: </strong>A qualitative study was used to explore the professional experiences of international HTA staff and their collaborators. Data were collected using three focus groups with 29 participants representing 20 HTA agencies or associated organizations. Framework analysis was used to identify themes from the transcripts.</p><p><strong>Results: </strong>HTA agencies frequently see submissions featuring surrogate endpoints. Issues they face include definitional concerns, absent or weak evidentiary links, and resource-intensive validation methods. Versatile guidance that is mindful of these challenges, such as those faced with rare diseases, is required. This would help to clarify expectations and help ascertain the required information from industry for economic modeling, on how to present the uncertainty arising from surrogate endpoints, and how to appropriately report the findings.</p><p><strong>Conclusions: </strong>Decision making using surrogate endpoints is a frequent and challenging problem faced by HTA agencies. These results provide the first-hand experiences and reflect the needs of HTA agencies globally. The resulting recommendations and considerations for the use of surrogate endpoints in economic modeling should benefit HTA agencies moving forward.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e69"},"PeriodicalIF":3.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}