Periodic Reporting for period 1 - IMPACT HTA (Improved Methods and Actionable Tools for Enhancing Health Technology Assessment)
Reporting period: 2018-01-01 to 2019-06-30
• Contribute to understanding the variations in costs & health outcomes within and across countries through methodological improvements;
• Develop & disseminate innovative methodologies, toolkits and processes in areas such as extrapolation from RCT data, costing, outcomes measurement, value assessment, real world evidence, aiming to aid decision-making and improve efficiency in resource allocation;
• Develop and disseminate tools facilitating cross-country collaboration across EU Member States, HTA agencies, professionals and other stakeholders.
WP2: (a) Conducted scoping study of literature on extrapolation techniques, including brief internal summary paper; (b) relating to the development of Excel-based platform to allow direct modelling of CEA by HTAs: (i) completed specification of new platform (DICE model); (ii) completed first case-study (conversion of existing HTA model); (iii) developed survey of HTA experts’ preferences for the platform; and (c) made numerous presentations, workshops and trainings using platform’s current version.
WP3: (a) A scoping review of literature and documentation on accounting and costing practices and a related article; (b) built and validated draft of the European Health Care Costs Database (EU HCCD), and health costs from other sources; and (c) conducted one online workshop to discuss methodological and technical aspects of EU HCCD.
WP4: (a) Revised methodological aspects applied to the identification, measurement and valuation of social costs in economic evaluations; (b) Alzheimer’s disease case study (to be published) to quantify ways of incorporating social perspective in economic analysis; (c) ongoing case studies & synergies with WP5 & WP8; (d) developing conceptual framework of database platform and created a draft database on unit costs relating to lost work time and the value of informal & formal care time.
WP5: Focused on preparation of methodology and tools, including questionnaire instrument & online survey: (a) completed translation/adaptation process of necessary language versions of EQ-5D-Y; (b) prepared experimental design of discrete choice experiment (DCE) defining attribute combinations and the levels of described health states was established and the different designs (patient and adult/adolescent survey); (c) nearly completed programming of adult/adolescent survey; (d) sub-design of EQ-5D-5L valuation studies was adopted in patient survey, to allow comparisons with existing data.
WP6: Conducting large-scale meta-epidemiological review: (a) developed (and published on online repository) detailed protocol for empirical investigation of discrepancies in treatment effects between randomised & non-randomised studies; (b) compiled dataset of clinical topics with matching randomised and non-randomised studies using various analytical techniques (to be analysed next).
WP7: (a) Developed model analysing determinants of HTA coverage recommendations across settings; (b) completed study on orphan drugs on determinants of HTA recommendations and the role & relative importance of criteria to inform coverage; (c) published a systematic literature review (SLR) of the methodological quality of multi-criteria decision analysis (MCDA) in HTA applications; (d) created & tested empirically a framework to identify stakeholders engaging in HTA; and (e) conducted research to (i) identify key features for a novel value framework and (ii) how a web-Delphi can be designed to promote participant consensus and interaction participants.
WP8: Conducted three literature reviews, which led to the development of two tools providing material, insights and evidence to fulfil the objectives of the WP: (a) online survey (investigating the influence of contextual factors on the implementation of technology and on clinical evidence-based decision-making; and (b) a semi-structured interview guide (to enable insights to be captured through direct interviews of senior staff).
WP9: (a) Designed basic framework integrating the combined effects on tax revenues and income decreases due to health conditions on patients, enterprises and employers; (b) conducted literature review to identify methods (human capital approach and friction costs methods) and their contribution to support the implementation of an integrated framework; and (c) completed tools to collect data from employers and diabetes patients.
WP10: (a) Completed vignettes of HTA appraisal processes for rare disease (RD) treatments; (b) completed an SLR of mapping approaches to derive health state utility values (HSUVs) from disease specific PROMs in RDs; (c) developed a database of Italian managed entry agreements (MEA) relating to OMPs to compare financial- vs outcome-based MEAs; (d) undertook ethnographic observation of products going through appraisal in Scottish setting (SMC) with follow-up interviews to explore how evidence is judged in deliberative settings compared with stated processes.
WP11: (a) Completed SLR to identify and categorise technologies offering prospects for efficiency gains outside incremental innovations captured in the northeast quadrant of the cost-effectiveness plane, (identified 94 decrementally cost effective (d-CE) interventions); (b) completed research on possible publication bias due to lack of interest in health technologies representing cost and quality reduction profiles.