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Value assessment of disease-modifying therapies for Relapsing-Remitting Multiple Sclerosis: HTA evidence from seven OECD countries

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  • Visintin, Erica
  • Tinelli, Michela
  • Kanavos, Panos

Abstract

This study systematically compares HTA recommendations on a number of disease–modifying therapies for patients with Relapsing-Remitting Multiple Sclerosis. We analysed publicly available HTA reports for nine medicine-indication pairs across seven OECD countries using a methodological framework enabling systematic analysis of HTA recommendations. The analysis was conducted based on a number of value dimensions, including clinical and economic variables, as well as several other dimensions of value beyond cost-effectiveness. The material was qualitatively and quantitatively coded following the different stages of HTA decision-making process. Fifty-seven medicine-indication pairs were assessed across the study countries. Of those, eight medicine indication-pairs reported diverging HTA recommendations. Although HTA recommendations were based on the same evidence submitted in most cases, significant variations were identified in interpretation and acceptance of evidence resulting in different uncertainties raised and different ways of addressing them. Uncertainties arose both in terms of the clinical and the economic evidence, including the design of key trials or the data quality in economic models. Beyond costs and effects, additional dimensions of value had an impact in the direction of recommendations, however with different magnitude across countries. We show that there is heterogeneity across countries in HTA for evaluating DMTs for RRMS with a lack of standardised methods in evaluating clinical and economic evidence and the use of social value judgments to inform decision-making.

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  • Visintin, Erica & Tinelli, Michela & Kanavos, Panos, 2019. "Value assessment of disease-modifying therapies for Relapsing-Remitting Multiple Sclerosis: HTA evidence from seven OECD countries," Health Policy, Elsevier, vol. 123(2), pages 118-129.
  • Handle: RePEc:eee:hepoli:v:123:y:2019:i:2:p:118-129
    DOI: 10.1016/j.healthpol.2018.08.019
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    References listed on IDEAS

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    2. Gisela Kobelt, 2006. "Costs and quality of life for patients with multiple sclerosis in Belgium," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(02), pages 24-33, July.
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    Cited by:

    1. Fontrier, Anna-Maria & Visintin, Erica & Kanavos, Panos, 2022. "Similarities and differences in Health Technology Assessment systems and implications for coverage decisions: evidence from 32 countries," LSE Research Online Documents on Economics 112969, London School of Economics and Political Science, LSE Library.
    2. Fontrier, Anna-Maria & Kamphuis, Bregtje W. & Kanavos, Panos, 2023. "How can health technology assessment be improved to optimise access to medicines? Results from a Delphi study in Europe," LSE Research Online Documents on Economics 120537, London School of Economics and Political Science, LSE Library.
    3. Anna-Maria Fontrier & Erica Visintin & Panos Kanavos, 2022. "Similarities and Differences in Health Technology Assessment Systems and Implications for Coverage Decisions: Evidence from 32 Countries," PharmacoEconomics - Open, Springer, vol. 6(3), pages 315-328, May.

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