Evidence map›Paper›PMID 41559793›Full record

ReviewHealth research policy and systems2026

Health technology reassessment and disinvestment instruments: a scoping review.

David Aluga, Shibu Shrestha, Claire Gorry, Adam G Elshaug, Paula Byrne, Patrick Gillespie, David Mockler, Susan M Smith

Abstract readScoping ReviewReview
In one paragraph

Review in Health research policy and systems, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David AlugaDiscipline of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland. alugad@tcd.ie.
Shibu ShresthaRCSI University of Medicine and Health Sciences, Dublin, Ireland.
Claire GorryHealth Service Executive-Medicines Management Programme, Trinity Centre for Health Sciences, St James's Hospital Dublin, Dublin, Ireland.
Adam G ElshaugCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Paula ByrneCentre for Health Research Methodology, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.
Patrick GillespieJ.E. Cairnes School of Business & Economics, University of Galway, Galway, Ireland.
David MocklerJohn Stearne Medical Library, St James's Hospital Dublin, Dublin, Ireland.
Susan M SmithDiscipline of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland.

Funding

Health Research Board SPHeRE-2022-1
6 · The paper itself

Abstract

introductionEvidence on safety, clinical and cost-effectiveness forms a key part of Health Technology Assessment (HTA) value appraisal for new health technologies and is often used to inform reimbursement and market access decisions. However, value may depreciate over the lifecycle of technologies, requiring reassessment to inform disinvestment decisions. This scoping review aimed to synthesise the evidence on tools that address Health Technology Reassessment (HTR) and disinvestment decision-making processes, with a view to identifying the key elements of an appropriate HTR and disinvestment model.

methodsThe scoping review was guided by the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the keywords "tool" "disinvestment" and "health technology reassessment", studies published in the English language were identified from the following databases: EMBASE, Medline, CINAHL, Web of Science Core Collections, and Google Scholar. Additional sources of unpublished studies and grey literature included websites and databases of Health Technology Assessment International (HTAi), International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and members of the International Network of Agencies for Health Technology Assessment (INAHTA). The studies were screened, and the data extracted from the included studies were mapped to our predefined conceptual framework and synthesised narratively.

resultsNineteen studies conducted in nine different countries were included in the scoping review. Most of the studies were conducted in high-income countries with formal HTA processes and nine studies conducted in or by researchers in Canada. The studies proposed different frameworks to guide the HTR and disinvestment process, only four of which have been validated in a real-world setting. There was generally underreporting of the sustainability component in proposed models as only three studies considered sustainability.

conclusionThis scoping review synthesised available evidence on HTR and mapped the attributes of tools in the included studies to our predefined conceptual framework. Our results suggest that a stronger focus on sustainability and a consistent stakeholder engagement process may improve implementation of disinvestment frameworks and tools. Further work on contextualising models to the local setting and beyond HTA-related processes would be required.

Indexed as

Biomedical TechnologyCost-Benefit AnalysisDecision MakingTechnology Assessment, BiomedicalCost-Effectiveness AnalysisHumans

Identifiers

PMID41559793
PMCPMC12903483

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.