POSA260 Common Drivers in Countries That Are Developing HTA Systems Had Led to Shared Challenges for Innovative Therapies

To understand the drivers and challenges facing countries transitioning towards full implementation of Health Technology Assessment (HTA) in the Asia Pacific, Latin America and Europe. We conducted a literature review focusing on HTA systems of 11 selected countries (Argentina, Columbia, Mexico, South Korea, Singapore, Philippines, Malaysia, Vietnam, Austria, Slovakia, and Greece). The literature review was followed by interviews with reimbursement decision-makers to supplement the findings. One of the most important common drivers that have been associated with the initiation of HTA systems was government initiatives to provide universal healthcare. This driver was common across countries despite different healthcare system structures. In the newly initiated HTA systems that we investigated, some of the HTA frameworks used for assessment have led to problems with access to innovative treatments. For example, conservative and strict application of the World Health Organisation's Incremental Cost-Effectiveness (ICER) threshold based on country GDPs can hinder patients’ access to innovative and irreplaceable treatments, although this practice might help establish fiscal discipline to enable the provision of universal healthcare. We also found that HTA has been used to inform efficient healthcare resourcing, such as value-based contracting, and to identify inexpensive but equally effective alternatives (for example, generics and biosimilars). Using HTA assessments in this way, HTA can open opportunities to create budgetary headroom for innovative medicines. Our analysis of 11 countries that are transitioning towards full implementation of HTA systems indicate that they are also facing budgetary constraints in providing better healthcare to broader populations. Some HTA approaches that these countries use focus narrowly on easing the budgetary burden of drugs. This practice hinders patients’ access to innovative and irreplaceable treatments. Instead, HTA can be used to find creative solutions to create budgetary headroom for all necessary medications. This approach will require collaboration across stakeholders, including governments and manufacturers.