Health technology assessment and comparative effectiveness research: a pharmaceutical industry perspective

Abstract

We briefly review the characteristics of several established health technology assessment (HTA) programs in industrialized societies including Germany, the UK and France. Special attention is paid on two issues: the position of HTA in coverage decision making and the role of economic assessment in evaluation processes. Although law makers in the USA have barred the use of NICE’s cost/quality-adjusted life year or similar health economics approaches by public payers for coverage decision making, there are suggestions of prioritizing relative efficacy evaluation over economic assessment under a comparative effectiveness research (CER) framework to inform payment rates of public payers (an approach similar to German and French HTA processes). However, such an approach is unlikely to prove viable. It should also be noted that, if cost considerations are made explicit in US CER policy decisions, CER may become an unsustainable approach undermined by a conflicting emphasis on both cost containment and a demand for costly comparative evidence. On the other hand, properly designed CER initiatives can serve as a facilitator of more efficient research activities and drug development models. With these points in mind, the likely pathway of US CER is explored and the plausible impact on industry innovation is discussed.

Keywords::

• comparative effectiveness research
• HAS
• health economics
• health technology assessment
• IQWiG
• NICE
• pharmaceuticals
• US healthcare reform

Acknowledgments

The authors would like to thank Kathy Buto, Vice President Health Policy at Johnson & Johnson, Bob Donnelly, Senior Director Global Policy at Johnson & Johnson, and Koen Torfs, Vice President Health Economics & Market Access at Johnson & Johnson, for their insightful review of the manuscript.

Financial & competing interests disclosure

Both authors are employees of, and shareholders in, Johnson & Johnson. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.