ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2023
Health technology assessment criteria as drivers of coverage with managed entry agreements: a case study of cancer medicines in four countries.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Impact of Market Access Delays on Time to Patient Access: Multi-Country Comparative Analysis Assessing the First Commercial Launch Indications for Five Oncology Medicines Across Europe and Canada.Journal of market access & health policy · 2026Article
- The value-for-money assessment and funding arrangements for high-priced drugs in an era of uncertainty: a comparative analysis of national health technology assessment agencies in South Korea, England, Australia, and Canada.BMC health services research · 2025Article
- Health technology assessment and innovation: here to help or hinder?International journal of technology assessment in health care · 2024Review
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1 author.
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Abstract
backgroundManaged entry agreements (MEAs) continue to emerge in health technology assessment (HTA)-based decision-making, to address evidentiary uncertainties arising therein. Evidence on the HTA criteria that influence MEAs' uptake remains scarce. This study explores the HTA criteria that determine (i) if an HTA funding decision will be listed with conditions (LWC) other than a MEA, or with a MEA as a condition (LWCMEA), and ii) the MEA type implemented (i.e., financial, outcomes based, or combination).
methodsHTA reports of all oncology medicines approved since 2009 in Australia, England, Scotland, and Sweden were searched to capture the clinical/economic evidence uncertainties raised in the decision-making process, the Social Value Judgements (SVJs) considered therein and the final coverage decision. Binary and multinomial logit models captured the probability (odds ratio (OR)) of a coverage decision being LWCMEA vs. LWC, and of the MEA being financial, outcomes based, or combination, based on the HTA criteria studied.
results23 (12%) LWC and 163 (88%) LWCMEA decisions were identified; 136 (83.4%) comprised financial, 10 (6.2%) outcomes based and 17 (10.4%) combination MEAs. LWCMEA decisions were driven by economic model utilities' uncertainties (7.16 < OR < 26.7, p < .05), and the innovation (8.5 < OR < 11.7, p < .05) SVJ. Outcomes based contracts were influenced by clinical evidence (OR = 69.2, p < .05) and relevance to clinical practice (OR = 26.4, p < .05) uncertainties, and rarity (OR = 46.2, p < .05) and severity (OR = 23.3, p < .05) SVJs. Financial MEAs were influenced by innovation (8.9 < OR < 9.3, p < .05) and societal impact (OR = 17.7, p < .0001) SVJs.
conclusionsThis study provides an empirical framework on the HTA criteria that shape payers' preferences in funding with MEAs, when faced with uncertainty.
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