The transferability of health technology assessment: the European perspective with focus on central and Eastern European countries

ABSTRACT

Introduction

Lower-income European countries have a worse health status and less funds for health care compared to Western Europe. Despite their limited human and financial capacities for conducting Health Technology Assessment (HTA), the need for evidence-based decision-making is growing. Two main approaches emerged as potential solutions: joint clinical assessments on the European level, and simplified procedures relying on the judgments of well-established HTA agencies of Western countries.

Areas covered

Based on considerations of transferability, the European Network for Health Technology Assessment (EUnetHTA) was built up to harmonize HTA methodologies across the European Union, and to develop an HTA Core Model by focusing on joint production of relative effectiveness assessment, which can be used as a basis for national value assessments. The second approach has been suggested in various forms without considering transferability issues.

Expert opinion

Joint clinical assessments reduce duplication of efforts based on appropriate scientific rationale. On the other hand, recent examples show that relying on judgments of HTA agencies from wealthier countries with potentially different health-care priorities can lead to suboptimal allocation decisions. In the short term, some stakeholders may benefit from ignoring transferability, but it will ultimately lead to limited access in other disease areas.

KEYWORDS:

• Central and Eastern Europe
• EUnetHTA
• health policy
• health technology assessment
• transferability

Article highlights

• Central and Eastern European countries generally have a worse health status and less public resources for health care; therefore, they have an even greater need to make well thought-out, evidence-based policy decisions.

• Health technology Assessment (HTA) is a tool that when applied adequately, can support unbiased, evidence-based decision-making in health care.

• Transferability of HTA needs to be taken into account, when looking for a right balance between avoiding duplication of work by HTA bodies, and maintaining scientific accuracy and policy relevance.

• If transferability is not considered, and results of cost-effectiveness analyses are used as a basis of decisions in other jurisdictions, the decision-making framework loses its scientific foundation.

• The HTA Core Model approach encourages explicit considerations on the transferability of relative effectiveness assessment across countries and recommends national HTA assessment based on similar methodologies, which ultimately reduces duplication of efforts while adhering to key scientific principles.

Declaration of interest

The authors have summarized their independent professional opinions. The content of this paper, as well as the views and opinions expressed therein are those of the authors and not necessarily their affiliated organizations. No writing assistance was utilized in the production of this manuscript. The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.