Health Technology Assessment International (HTAi), Perth, WA, Australia.
Health Technology Assessment International (HTAi), Edmonton, AB, Canada.
Int J Technol Assess Health Care. 2023 Feb 23;39(1):e15. doi: 10.1017/S0266462323000090.
Lifecycle considerations have always been part of health technology assessment (HTA). However, the concept of taking a fuller, more holistic "lifecycle approach" is gaining interest in the HTA community. The 2022 HTAi Global Policy Forum (GPF) discussed how adopting a lifecycle approach could promote stakeholder engagement and robust evidence generation, and whether it could enhance information sharing and transparency across stakeholder groups. This article summarizes the discussions held at the 2022 HTAi GPF and subsequent HTAi Annual Meeting panel session that debated some of the key challenges and opportunities, with particular focus on the pre- and postmarket and disinvestment phase activities. Core themes and recommendations identified that collaboration and patient involvement are happening but still needs to be strengthened, and moving to disease-based approaches may help, although individual contexts still need to be considered. Appropriately developed and mandated core outcome sets may help with information sharing and efficiency in all lifecycle activities. Further, methods for the appropriate use of big data and digital data collection should be developed and driven by the HTA community. The value of lifecycle activities should be reviewed; in particular, scientific advice appears valuable, but the magnitude of effect is somewhat unknown due to the challenges around the confidential nature of these activities. Not all lifecycle activities can be conducted for every technology, and while there is a move away from disinvestment phase activities, more structured prioritization criteria are required. This article ends with suggested next steps to bring forward some of the priority recommendations.
生命周期考虑因素一直是健康技术评估(HTA)的一部分。然而,采用更全面、更整体的“生命周期方法”的概念在 HTA 社区中越来越受到关注。2022 年 HTAi 全球政策论坛(GPF)讨论了采用生命周期方法如何促进利益相关者的参与和强有力的证据生成,以及它是否可以增强利益相关者群体之间的信息共享和透明度。本文总结了在 2022 年 HTAi GPF 上进行的讨论以及随后在 HTAi 年会上进行的小组讨论,这些讨论涉及一些关键的挑战和机遇,特别关注了上市前和上市后以及撤资阶段的活动。确定了一些核心主题和建议,即合作和患者参与正在发生,但仍需加强,转向基于疾病的方法可能会有所帮助,尽管仍需考虑个别情况。适当制定和授权的核心结果集可能有助于在所有生命周期活动中进行信息共享和提高效率。此外,HTA 社区应开发和推动适当使用大数据和数字数据收集的方法。还应审查生命周期活动的价值;特别是,科学咨询似乎很有价值,但由于这些活动的保密性带来的挑战,其影响的幅度尚不清楚。并非所有的生命周期活动都可以针对每一项技术进行,虽然正在逐步减少撤资阶段的活动,但需要更具结构性的优先排序标准。本文最后提出了一些建议,以推动一些优先建议的实施。