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REFERENCES1. Proposal for a regulation of the European Parliament and of the Council on health technology assessment and amending Directive 2011/24/EU. COM/2018/051 final - 2018/018 (COD)2. https://www.eunethta.eu/national-implementation/national-uptake-and-case-studies
Authors: Pieniążek I, Maciejewska K, Walczak JArcana Institute a Certara Company, Cracow, Poland
A total of 128 implementations in 25 countries have been identified. JA3 includes 10 assessed technologies (3 drug and 7 non-drug technologies) and JA2 includes 15 assessed technologies (7 drug and 8 non-drug technologies).2
RESULTS
The EUnetHTA National Uptake and Case Studies subpage2 was searched and the use of the EUnetHTA JointAction 3 (2016-2020) and Joint Action 2 Archive (2012-2015) assessments were analysed. Based on the EUnetHTAinformation about details of the use of REAs, assessments were categorised into 10 groups: adaptation, summary,translation, update, indexed in NHS evidence database, new items added, background, validation/cross-checking,used in direct decision-making, mentioned in the discussion. This analysis was based on publicly available data.The last verification was performed at the beginning of October 2018.
METHODS
OBJECTIVE
In January 2018, a proposal for a regulation of the European Parliament and of the Council on health technologyassessment and amending Directive 2011/24/EU was adopted.1 The proposed regulation aims to strengthen EUcooperation in terms of joint HTA (health technology assessment). The objective of this analysis is to assess howcurrent EUnetHTA REAs (Rapid Relative Effectiveness Assessments) have been implemented by national agencies.
Chart 1. Technologies Assessed by EUnetHTA
Chart 4. Number of drug technologies implementations
CONCLUSIONThe analysis shows that limited number of countries uses REA implementations, since only a few EU countriessupport their reimbursement processes with comprehensive HTA analyses performed by EUnetHTA. It is alsoconfirmed by the proposal for a regulation of the European Parliament and of the Council, which presented theEUnetHTA concept as unsuccessful in terms of eliminating duplication of work and fragmentation of the internalmarket. Before further legislation steps are taken, it is worth to investigate what the reasons for failing to reach forsuch a comprehensive source of information as EUnetHTA analyses are. The diagnosis may have a positive impacton more prevalent use of EUnetHTA assessments as a relevant source of information supporting reimbursementdecisions on the level of specific countries.
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ISPOR 21th Annual European Congress
10-14 November 2018
Barcelona, Spain
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JA3 JA2
TECHNOLOGIES ASSESSED BY EUNETHTA
All assessed Drugs assessed
Implementation on country level Implementation of drug assessment
The implementation ratio for drug to non-drug technologies was 45% to 55% (40% to 60% in JA3 and 47% to 53% in JA2).
Chart 2. Implementation ratio for drug to non-drug technologies
45%
55%
IMPLEMENTATION RATIO FOR DRUG TO NON-DRUG TECHNOLOGIES
drug implemented
non-drug implemented
47%53%
JA2
drug implemented
non-drug implemented
40%
60%
JA3
drug implemented
non-drug implemented
Within drug technologies, 2 technologies with 21 implementations in JA3 and 7 technologies with 41implementations in JA2 were identified. The most implementations were found for canaglifozin (12 agencies in 10countries) and ragorafenib (11 agencies in 9 countries).
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JA3 JA2
Number of implementations
Implemented technologies
RESULTS (cont.)Among the countries which used EUnetHTA REAs most often, Austria (23), Spain (19) and Croatia (19) dominated.Summary (33 cases) and adaptation (29 cases) were the most frequently used types of EUnetHTA assessments.
3031
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7
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1726
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22 3
Adaptation
Summary
Translation
Update
Indexed in NHS Evidencedatabase
New items added
Background
Validation/cross-checking
Used in direct decision-making
Mentioned in the discussion
T Y P E O F I M P L E M E N TAT I O N
Implementation of REA in direct decision-making was identified for 6 countries, of which Austria had the greatestnumber of cases (8). Croatia is the country with implementations for almost all analysed technologies, howeveronly a summary of the report was the most common type of implementation there.
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11 1
ASSESSMENTS USED IN DIRECT DECISION-MAKING
Austria Spain Slovakia
Netherlands Portugal Malta
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A DA P TAT I O N
Austria Spain Italy Scotland Portugal Finland Denmark Norway Lithuania Slovenia Ireland
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S U M M A RY
Austria Croatia Spain
Italy Belgium Denmark
Chart 5. Implementations in countries
Chart 3. Number of drug technologies implementations
Chart 6. Type of Implementation
Chart 6. Type of Implementation by Country
A U S T R I A 23C R O AT I A 19S PA I N 19I TA LY 8S L O VA K I A 7B E L G I U M 7S C O T L A N D 5U K 5N E T H E R L A N D S 4P O R T U G A L 4F I N L A N D 3D E N M A R K 3F R A N C E 3L U X E M B O U R G 2S W E D E N 3H U N G A R Y 2N O R WAY 2L I T H U A N I A 2M A LTA 1R O M A N I A 1S L O V E N I A 1E S T O N I A 1S W I T Z E R L A N D 1I R E L A N D 1P O L A N D 1
Alcensa:
Vorapaxar:
Immunoglobulins AD:
Hepatitis C:
Zostavax:
Sorafenib:
Midostaurin:
Ramucirumab:
Regorafenib:
Canaglifozin:
N U M B E R O F D R U G T E C H N O LO G I E S I M P L E M E N TAT I O N S
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ANALYSIS OF THE NATIONAL IMPLEMENTATION OF
EUNETHTA REA AND FULL ASSESSMENTS
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