Will Australia’s HTA framework keep pace? New international group challenges traditional health economics methods

An international consortium of health technology assessment (HTA) agencies has joined forces to tackle emerging challenges in health economic methods, including dynamic pricing and non-traditional approaches to evaluating value in cost-effectiveness analyses.

The Health Economics Methods Advisory Group (HEMA) is an independent collaboration between HTA bodies from the United States, England, and Canada. The group’s primary mission is to develop recommendations for adopting novel health economic methods to guide healthcare systems. HEMA will also address potential modifications to existing methods, explore uncertainties in applying new methodologies, and propose areas for further research.

Sarah Emond, ICER’s President and CEO, highlighted the organisation’s commitment to advancing methods development, saying “We re-examine our Value Assessment Framework every few years, convene a Methods Advisory Group several times per year, and solicit feedback on our analyses and processes from stakeholders across the health system.”

Emond emphasised the potential for global impact, saying, “Through HEMA, we hope to engage regularly with the international HTA community to discuss the advantages and drawbacks of new methods. And while implementation will vary across regions, this is an opportunity for the broader health economics community to critically examine and potentially pilot the feasibility of new approaches to HTA.”

Nick Crabb, Chief Scientific Officer at England’s National Institute for Health and Care Excellence (NICE), underscored the need for this initiative, citing the “era of unprecedented innovation in medicines and health technologies” as a driving force.

He added, “HEMA will provide an authoritative, international voice in key methodological areas where there are high levels of potential, controversy and challenge.”

The Association of the British Pharmaceutical Industry (ABPI), representing the UK’s research-based industry, has welcomed HEMA’s creation. Victoria Jordan, ABPI’s Head of HTA and Market Access Policy, noted the importance of collaboration in advancing health technology assessment methods.

“We look forward to engaging in these important discussions on new HTA methods and approaches, ensuring their continuing evaluation remains sensitive to how they could impact patients and their access to medicines, both here in the UK and internationally,” Jordan said.

These developments are relevant to the local market as Federal Health Minister, Mark Butler MP, sparked cautious optimism with last week’s announcement of the HTA Review Implementation Advisory Group (IAG). The announcement comes more than two years after the review began in October 2022. However, concerns linger over the government’s commitment to timelines and the scope of bold reforms, particularly with a looming election.

The international consortium, HEMA, plans to begin operations in early 2025. The group aims to facilitate independent assessments of health economics methodologies, fostering collaboration across borders. However, the structure of participation varies by country. While Canada and England’s HTA representatives are government agencies, the U.S. is represented by the independent non-profit Institute for Clinical and Economic Review (ICER). This distinction could limit HEMA’s influence on reimbursement decisions in the United States.

HEMA’s agenda may include exploring dynamic efficiency and pricing in economic models, incorporating novel or non-traditional value metrics in cost-effectiveness analyses, and integrating health equity considerations into quantitative assessments.

HEMA’s governance will include a steering committee representing patients, payers, and the life sciences industry. A working group with representatives from all three countries will provide diverse expertise and perspectives. HEMA will engage patients, methodologists, and industry stakeholders to provide actionable recommendations on novel methods, required modifications, and future research directions.

Invitations to join HEMA’s committees have been sent, though membership is yet to be finalised. The full list of members will be published on ICER’s website, according to Dan Ollendorf, ICER’s Chief Scientific Officer and Director of HTA Methods and Engagement.

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