OBJECTIVES: Explore health economic evaluation of medical technologies (devices, diagnostics, digital health technologies) (MTs). CONCLUSIONS: Economic assessment is linked to national contexts. Understanding key differences and similarities among HTA processes of priority stakeholders will be essential to demonstrate economic evidence efficiently to achieve market-access objectives for MT.
METHODS: An online survey enquiring about economic evaluation for MT was sent to 55 health technology assessment (HTA) organisations worldwide. Quantitative and qualitative data were obtained and analysed.
RESULTS: Of 15 respondent HTA organisations, 12 evaluated MTs. In addition to evidence submitted by the manufacturer toward the evaluation process, HTA bodies from Canada, Denmark, Finland, Norway, Spain, Tunisia, the United Kingdom (UK), and the United States conduct economic systematic literature reviews (SLRs). Topics considered in SLRs include utilities, health resource use/cost, and economic evaluations. Canada, Denmark, Finland, Japan, Norway, Spain, Sweden, Tunisia, and the UK consider economic evaluation. Canada, Denmark, and Tunisia cover a range of economic evaluation types, including cost-utility analysis (CUA), cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), costminimisation analysis (CMA), price comparison analysis (PCA), and budget-impact analysis (BIA). Sweden considers CUA, CEA, CBA, CMA, and PCA, while Norway considers CUA, CEA, CMA, and BIA. Both Spain and the UK consider CEA and BIA. Spain, and the UK also considers CUA and CMA, respectively; Japan only considers CUA. Not all HTA organisations reveal their willingness-to-pay threshold. Perspectives in economic evaluation also vary among perspectives on societal issues, health care systems, individual patients, specific institutions, and target groups of specific services. The UK (National Institute for Health and Care Excellence) discounts future cost at a rate of 3.5%. Other countries discount both future costs and outcomes. Rates range from 0% and 3% for Finland (Finnish Coordinating Center For Health Technology Assessment) to 5% for Canada (Canadian Agency for Drugs and Technologies in Health).
