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The Need for a “Living” Approach to HTAs

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Innovate or Continuously Be Outdated: The Need for a “Living” Approach to HTAs

Cytel moderator: Grammati Sarri



The recent COVID pandemic not only created the necessity but an opportunity to implement a responsive, innovative, “living” approach to health technology assessment (HTA). The need for change is not unique to the pandemic. With the increased pressure to provide patients with early access to new health technologies, the demand for continual data collection from both trials and real-world studies is rising. These pressures opened a discussion on whether HTA bodies need to evolve from the traditional approach of systematic reviews, which become instantaneously outdated, to a “living” approach using technological tools and methods capturing the constant stream of new evidence underpinning a living economic analysis and facilitating data sharing between organizations. So far, HTA bodies have been slow in adopting such innovation.


HTA bodies face significant challenges on how to obtain rapidly generated evidence on promising technologies efficiently and rigorously, paralleled with a demand to consider a wider evidence base, while still maintaining the same methodological standards under constrained time and resources. This panel will debate, from research, industry, and automation perspectives, if a new paradigm of “living HTAs” is the only real viable solution to efficiently respond to the rapidly evolving and complex treatment and evidence landscape. How can automated software companies and industry facilitate transparency and acceptance in the use of technology in the “living HTA” approach as a viable and only means to efficiently inform decision-making? What are the main methodological and operational challenges if moving toward a “living” standardized approach for all types of assessment? How can we establish a set of standards to minimize analytical time to process data, while optimizing certainty in decision-making? An interactive discussion will follow using real-time polling questions. Stakeholders (industry, researchers, payers) will benefit from this panel.


We asked moderator Grammati Sarri, Senior Research Principal, RWA Health Economics, to share her insight on this upcoming panel discussion:


What motivated you to explore this topic and why is this moment significant? What are the stakes of the questions being explored?

The HTA and drug development landscape is changing at an unprecedent pace. New highly specialized products are trying to enter the market earlier, a huge volume of rapidly produced real-world evidence is generated from different sources while HTA decision-makers are trying to weigh in on the increased number of highly priced drugs with ensuring the sustainability of already hugely overburdened healthcare systems in the wake of the pandemic.

What was already becoming evident in recent years but was really revealed during the COVID-19 pandemic is that HTA processes need to be more responsive and dynamic to meet the evidentiary requests of twenty-first century. The single time-static HTA consideration of new products’ value (or single re-assessment in the case of post-market arrangements) may produce misleading conclusions by using out-of-date evidence. The living HTA approach, which encompasses a continuing (evolving) evidence generation and assessment, may be the only viable, real-time solution for the future of healthcare decision-making to address the current HTA challenges. This was universally recommended as part of the development of EU HTX Guidance on COVID-19 treatments. In addition, several countries are already using living clinical guidelines as part of setting routine clinical care (such as, England and Australia). So why are HTA bodies lagging behind? In our issue panel, we will outline the principles underscoring this new living approach and discuss how the technological advances in the automation of different steps in evidence synthesis (clinical, economic) during the last years can facilitate the implementation of the concept of living HTA. It would be interesting to hear from the audience as well about what you consider to be the strongest drivers to push HTAs to move forward toward a living technology assessment and understanding the potential roadblocks on this map.


How is Cytel positioned in this work? What can we offer our clients in regards to this topic?

Cytel has enormously invested in building up and testing the applicability of interconnected automation tools that can demonstrate the product’s value in real time; from LiveSLR and LiveNMA software using the power and scope of an artificial scan combined with the judgment of our systematic literature review experts and statisticians, to living tools related to economic modeling (LiveBIM, LiveOS, LiveUtility). We are strongly confident that these living tools will support the implementation of this new “living” HTA process and enable sponsors to comprehensively demonstrate the value of their products. Please feel free to contact us to learn more.


Cytel will be represented at over 60 presentations at ISPOR Europe 2022, with more issue panels and workshops than any other participating organization. To download the full Cytel program, click below. We look forward to seeing you there!


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