HTA programme response to the challenges of dealing with orphan medicinal products: Process evaluation in selected European countries

Elena Nicod, Lieven Annemans, Anna Bucsics, Anne Lee, Sheela Upadhyaya, Karen Facey

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: Challenges commonly encountered in HTA of orphan medicinal products (OMPs) were identified in Advance-HTA. Since then, new initiatives have been developed to specifically address issues related to HTA of OMPs.

OBJECTIVE AND METHODS: This study aimed to understand why these new HTA initiatives in England, Scotland and at European-level were established and whether they resolve the challenges of OMPs. The work of Advance-HTA was updated with a literature review and a conceptual framework of clinical, regulatory and economic challenges for OMPs was developed. The new HTA programmes were critiqued against the conceptual framework and outstanding challenges identified.

RESULTS: The new programmes in England and Scotland recognise the challenges identified in demonstrating the value of ultra-OMPs (and OMPs) and that they require a different process to standard HTA approaches. Wider considerations of disease and treatment experiences from a multi-stakeholder standpoint are needed, combined with other measures to deal with uncertainty (e.g. managed entry agreements). While approaches to assessing this new view of value of OMPs, extending beyond cost/QALY frameworks, differ, their criteria are similar. These are complemented by a European initiative that fosters multi-stakeholder dialogue and consensus about value determinants throughout the life-cycle of an OMP.

CONCLUSION: New HTA programmes specific to OMPs have been developed but questions remain about whether they sufficiently capture value and manage uncertainty in clinical practice.

Original languageEnglish
Article numberhttps://doi.org/10.1016/j.healthpol.2017.03.009
Pages (from-to)140-151
JournalHealth policy (Amsterdam, Netherlands)
Early online date28 Mar 2017
DOIs
Publication statusPublished - Feb 2019

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