Pathway framework 4 of 8
How to get a funding decision by appraising the evidence on a treatment
This pathway shows how an HTA body judges a new treatment and reaches a recommendation on whether it should be funded. It then covers how payers list the treatment and manage access to it.
2 steps
This framework organises the concepts covered at each step of the pathway on the Knowledge Map.
Concepts from other branches of the Knowledge Tree that this pathway builds on.
Step 1
How an HTA body reviews the evidence on a technology, and how a committee weighs that evidence against its decision criteria to reach a funding recommendation.
22 concepts
Why start here
The pathway starts with how a technology is assessed and appraised, because every later funding and access decision rests on that recommendation.
Step 2
How payers put a technology on a formulary and control its use, and how managed entry agreements let a technology be funded while doubts about its value or cost remain.
5 concepts
Why this comes next
Once an HTA body has made its recommendation, payers still have to set the terms on which patients get the technology, so access arrangements come next.
Branches that take these methods further.