Topic

HTA processes and methods

HTA bodies first assess the clinical and cost-effectiveness evidence on a technology, then an appraisal committee weighs it against decision criteria and makes a coverage decision, which consultees may challenge through an appeal process. Related concepts include the reference case, multi-criteria decision analysis, early health technology assessment and benefit grades such as the ASMR rating.

Concepts in this topic

• Accountability for ReasonablenessAccountability for reasonableness (A4R) is a fair-process framework for health priority setting: publicity, relevance, revisability and enforcement.
• Added Therapeutic ValueAdded therapeutic value is the extra patient-relevant benefit a new medicine gives over existing care, as graded by HTA bodies such as HAS and G-BA.
• AI Diagnostic ValueAI diagnostic value is the assessment of an AI diagnostic tool's net health and cost effect in a care pathway, judged on outcomes, not accuracy alone.
• Appeal ProcessThe appeal process in health technology assessment (HTA) lets consultees challenge a recommendation on set grounds, such as unfairness or unreasonableness.
• AppraisalAppraisal in HTA is the step after assessment in which a committee weighs the evidence and recommends whether a health technology should be funded.
• Appraisal CommitteeAn appraisal committee is an independent expert and lay panel in an HTA body that weighs clinical and cost-effectiveness evidence to recommend on funding.
• Artificial Intelligence in HealthArtificial intelligence in health is software that infers predictions or decisions from data, valued in HTA by its effect on costs and outcomes.
• ASMR RatingThe ASMR rating is the French HAS grade, from major (I) to none (V), of how much a medicine improves on existing treatments, used to frame its price.
• AssessmentAssessment in HTA is the evidence-review step before appraisal: analysts critically evaluate a technology's clinical and cost-effectiveness evidence.
• Clinical Algorithm DevelopmentClinical algorithm development is building a step-by-step diagnosis or treatment pathway from evidence review, consensus and often economic evaluation.
• Clinical GuidelineA systematically developed set of recommendations that uses reviewed evidence and explicit judgments to guide care for a defined population and setting.
• Coverage DecisionThe formal determination by a payer or assessment body regarding whether, and under what conditions, a technology will be reimbursed.
• DecisionA decision in health economics is a choice between alternative uses of health care resources, such as funding a technology, informed by evidence.
• Decision AlgorithmA decision algorithm is a fixed sequence of explicit rules that turns evidence into a decision, such as an outcome-level HTA benefit grade or a test order.
• Decision CriteriaDecision criteria are the factors an HTA body weighs in a funding recommendation, such as clinical benefit, cost-effectiveness and severity.
• Early Health Technology AssessmentThe assessment of a health technology during development to inform design, evidence generation, pricing and market-access strategy.
• Evidence SynthesisThe structured integration and appraisal of findings from multiple studies to answer a defined question while accounting for comparability, bias and uncertainty.
• Health Technology AssessmentHealth technology assessment (HTA) evaluates the clinical, economic, social and ethical effects of a drug, test, device or procedure to guide its use.
• MCDA in HTAMCDA in HTA uses multi-criteria decision analysis to appraise health technologies on explicit, often weighted, criteria such as health gain and severity.
• Multi-Criteria Decision AnalysisMulti-criteria decision analysis is a family of structured methods that compares alternatives across multiple explicit criteria and incorporates judgments about the trade-offs among them.
• Real Option ValueA component of a technology's value reflecting the benefit of extending life sufficiently to allow a patient to benefit from future medical advances.
• Reference CaseA reference case is the set of methods, such as perspective, outcome measure and discounting, that HTA bodies like NICE expect economic evaluations to use.