Forschung

In practice, HTA rests predominantly on two pillars: the assessment of clinical benefit drawing on principles of evidence-based medicine, and an evaluation of efficiency, usually by means of some variant of cost-effectiveness analysis (CEA). For example, well-known HTA agencies as the British National Institute for Health and Care Excellence (NICE) and the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA)/ Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) have implemented different evaluation approaches, which (may) also reflect variations in HTA outcomes.

Against this background, HTA comparative studies were conducted to explore the extent to which different methodological choices are associated with different HTA outcomes. The first study mainly focused on assessment and appraisal results as well as (official and unofficial) evaluation criteria by G-BA and NICE, respectively [1]. Another study also included the French Haute Autorité de Santé (HAS), primarily to compare HTA outcomes of matched drug pairs [2].

In a follow-up project, data requirements of the official HTA agencies have been systematically reviewed, including their acceptance of data sources and handling of potential bias. This analysis aimed to test (official) evaluation criteria including the potential role of budget impact on HTA outcomes published by G-BA and IQWiG in Germany as well as NICE in England [3].

Selected Publications

1. Schaefer, R., Schlander, M.: Is the National Institute for Health and Care Excellence (NICE) in England more ´innovation-friendly´ than the Federal Joint Committee (GBA) in Germany? Expert Review of Pharmacoeconomics & Outcomes Research. 2019; 19(4): 453-462
2. Schaefer, R., et al.: Health technology assessment (HTA) in England, France and Germany: What do matched drug pairs tell us about recommendations by national HTA agencies? Journal of Comparative Effectiveness Research. 2021; 10(16): 1187-1195
3. Schaefer, R., et al.: Socioeconomic Impact Analysis: Health Technology Assessment-Informed Decision Making by the Federal Joint Committee/ Institute for Quality and Efficiency in Health Care in Germany and the National Institute for Health and Care Excellence in England: The Role of Budget Impact. Value in Health. 2023; 26(7): 1032-1044