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What you need to know about health technology assessments

By Erin LanePamela Divack

June 30, 2020

    Our research on value analysis committees (VACs) revealed that roughly half of provider organizations used third-party performance technologies to support the value analysis process in 2019, and over 61% plan on using them in the future. Among these third parties are a growing number of health technology assessment (HTA) organizations.

    As providers increasingly use these tools in purchasing decisions, it's critical for suppliers to understand how HTAs work, why providers use them, how the HTA landscape is changing, and how suppliers can best position themselves for HTAs' assessments.

    Why providers turn to HTAs for help

    HTAs evaluate clinical and financial product evidence and conduct cost/benefit analyses to help providers assess the overall value of drugs, devices, and diagnostic technologies. Supply shortages and product deficiencies experienced throughout the Covid-19 crisis emphasize the potential value of tools like HTAs that enable providers to identify suitable alternatives and assess products prior to purchase.

    Many therapeutic areas, such as diabetes and cardiovascular, are crowded with similar products. Providers often struggle to assess meaningful differences among products or determine which difference will be most beneficial. With limited access to information on comparative effectiveness, providers turn to HTAs to compare available evidence, as well as to incorporate their data to support cost/benefit analyses.

    In addition, complex or niche therapeutic areas, such as rare disease and immuno-oncology, have many drugs, devices, and diagnostics with few competitors and limited clinical evidence. As such, providers struggle to evaluate these new products against the current standard of care. HTAs enable value assessments even in absence of robust outcomes data, appropriate use cases, and federal coverage policies that would normally guide their decisions.

    How the HTA landscape is evolving

    Traditionally, HTAs offered static reports that focused on product quality and strength of clinical evidence. However, we've seen HTAs rapidly evolve. Many now embed interactive decision-support tools and resources directly into value analysis workflows or EHRs. This helps providers understand evidence and assess purchasing options in real time.

    We evaluated over 30 new and existing HTA organizations and found they fell into four generations: evidence evaluators, guideline generators, value assessors, and decision-support resources. The table below summarizes the key attributes of each generation. The later-stage generations have not replaced Generation 1 or 2 offerings but rather added to the number and variety of third-party voices embedding themselves into the value analysis process.


    These technologies have also been essential in finding suitable alternatives for critical supplies throughout Covid-19. HTAs have the potential to play a central role in future health care supply chain strategy and operational overhauls as providers build contingency plans to avoid future shortages.

    3 ways providers use HTAs in the value analysis process

    1. Aggregate analytics. HTAs improve providers' data and analytics capabilities by gathering and assessing disparate clinical and financial data quickly. This increases the amount of data VAC and supply chain leaders can use to make decisions. It also speeds up the value analysis process, allowing VACs to revisit decisions more frequently.

    2. Facilitate holistic decision-making. Today, VACs use more—and more complex—metrics to determine value, including long-term outcomes, appropriate use cases, downstream costs, and revenue opportunities. HTAs provide insight into these metrics and take a longitudinal view of value into account when assessing data. They are, therefore, seen as reliable tools for comparing products throughout decision-making.

    3. Encourage appropriate use. Many HTAs offer decision-support tools that inform drug and device use at scale. For example, clinicians may turn to evidence quality reports or guidelines generated by HTAs at the point of care. As a result, providers are starting to integrate clinical evidence directly into their care decision workflows.

    3 ways suppliers can stay ahead of HTAs

    As providers increasingly rely on HTAs, there are three tactics suppliers should consider to stay ahead:

    1. Ask customers about their value analysis needs and challenges. Understanding providers' needs, such as more real-world evidence or budget impact models, can provide insight into how and why they rely on HTAs. You can use this information to provide more valuable data in the future and supplement their HTA use.

    2. Improve collaboration between commercial and medical leadership to fuel evidence generation and enable more targeted value assessments. Commercial and medical colleagues have a wealth of unique insight that can predict providers' evidence demands, such as comparative effectiveness and long-term outcomes. This insight can, in turn, enable medical teams to generate evidence that matters to both HTAs and providers.

    3. Engage with HTAs early and often. Many HTAs are open to collaborating with suppliers and welcome their data and evidence submissions—not only randomized control trials, but real-world evidence and cost analysis among others. Early engagement can help HTAs understand products better, and in turn fuel more accurate analysis.

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