Tuesday, June 18, 2024

Enhancing Patient Involvement in Health Technology Assessments Across Europe

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Across Europe, while most countries utilize health technology assessment (HTA) to evaluate the clinical and economic evidence of medications for reimbursement through public healthcare systems, the degree and manner of patient involvement in this process vary significantly. This variability often leaves the precise impact of the patient voice on crucial healthcare decisions somewhat ambiguous.

The European Commission is set to introduce a more standardized approach through the Regulation on HTA (HTAR), which will be effective from 2025. This new regulation provides a prime opportunity to refine how patients are integrated into the health technology assessment process, aiming for a more inclusive and effective system.

The EFPIA Patient Think Tank, in collaboration with the Patient and Citizen Involvement in HTA Interest Group (PCIG) at HTAi, the European Patient Forum (EPF), and the European Patient Academy for Technological Innovation (EUPATI), embarked on a project in 2022 to delve into stakeholder experiences with patient involvement in health technology assessment. Funded by EFPIA and PhRMA, this project utilized in-depth interviews and a Europe-wide survey to pinpoint exemplary practices.

Improving Patient Engagement in Health Technology Assessment Processes

One notable finding from this study is the realization that patient involvement is possible at every stage of the HTA process. Methods of engagement vary, including written submissions, interviews, focus groups, and seats on appraisal committees or organisational boards. However, no country was found to consistently involve patients in all stages of the process, and there was a significant lack of consistency in how patient input was integrated into HTA reports, recommendations, or subsequent decisions.

Despite some progress, there remain several areas where the current approach to patient involvement in health technology assessment could be improved:

  • Outreach and Education: The survey indicated that many patients are unaware of HTA and how they can participate. There is a crucial need for targeted education and training to enable meaningful patient involvement.
  • Feedback and Guidance: The absence of constructive feedback and clear guidelines for evaluating patient contributions leads to low motivation among patients to engage in the HTA process.
  • Institutional Memory: A lack of continuity and record-keeping within patient organizations limits the accumulation and transfer of knowledge and experience related to HTA involvement.

Health Technology Assessment

Proposed Strategies for Enhancing Patient Involvement in European Health Technology Assessment Practices

Based on the findings, several recommendations have been proposed to foster more effective patient involvement in health technology assessment:

  • Establish Standing Committees: Implement advisory boards or standing committees that focus on patient and public involvement to ensure consistent and structured engagement.
  • Develop Accessible Resources: Produce fit-for-purpose guidance, training, and informational materials in lay language to help demystify the technical aspects of HTA for patients.
  • Encourage Learning and Development: Recognize that involving patients is a developmental process for stakeholders at all levels. Efforts should aim to make this involvement rewarding and productive, ensuring that all parties feel their contributions are valued.

By adopting these practices and leveraging the upcoming HTAR framework, there is a strong potential to elevate the standards of patient involvement in health technology assessment across Europe. This collaborative approach promises not only to enhance the decision-making process but also to ensure that it becomes more patient-centered and transparent.

 

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Resource: European Federation of Pharmaceutical Industries and Associations, May 15, 2024

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