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  • Article
  • Open Access

Structural Enablers of Rare Disease Treatment Coverage in Latin America and the Caribbean: Lessons from Emicizumab

  • Daniela Sugg Herrera,
  • Dino Sepúlveda Viveros,
  • Moisés Russo Namias and
  • Natalia Garrido

We examine how structural characteristics of health systems in Latin America and the Caribbean (LAC) shape access to innovative therapies, using emicizumab for hemophilia A as a case study. Although the therapy is available in the region, access rema...

  • Article
  • Open Access

Background: Value-based pricing has the potential to contribute to the appropriate allocation of healthcare expenditures. We developed the “MARIE”, a qualitative scheme that evaluates broad value elements without requiring a comparator to...

  • Opinion
  • Open Access
414 Views
15 Pages

Optimising Investment in Health Innovations in Europe

  • Tosin Adeyemo,
  • Tim Wilsdon,
  • Christina Vandorou,
  • Fiona Davies and
  • Annabelle Godet

European citizens made it clear in 2024 that healthcare should be the EU’s top priority for shaping the future of Europe. This sentiment reflects the escalating health challenges facing the region, driven by ageing populations, rising chronic d...

  • Article
  • Open Access
274 Views
19 Pages

Adopting a Societal Perspective in Health-Economic Evaluation: Analysis of Nine HTA Methodological Guidelines on How to Integrate Societal Costs

  • Chloé Gervès-Pinquié,
  • Hortense Nanoux,
  • Sarah Akarkoub,
  • Rémi Brazeilles,
  • Henri Bonnabau and
  • Katell Le Lay

Objective: The perspective applied in Health Technology Assessment (HTA) has recently been presented as a central methodological debate in HTA. Beyond expected effects on patients’ health and quality of life, health technologies can affect broa...

  • Article
  • Open Access
327 Views
17 Pages

Pulmonary Arterial Hypertension and Cancer: Unveiling Parallels in Epidemiology, Clinical Pathways, and Therapeutic Strategies

  • Karim EI-Kersh,
  • Nadine Zawadzki,
  • Catelyn Coyle,
  • Shurui Zhang,
  • Dhruv Dalal,
  • Anna Watzker,
  • Dominik Lautsch and
  • Jason Shafrin

Pulmonary arterial hypertension (PAH) and cancer share high mortality and complex prognoses. Due to PAH’s rarity, these parallels may be underrecognized by healthcare stakeholders. This study explored similarities between PAH and cancer across...

  • Article
  • Open Access
429 Views
24 Pages

A Cost-Effectiveness Analysis of the Sentio Bone Conduction Hearing Implant System in the Australian Healthcare Setting

  • Magnus Värendh,
  • Ida Haggren,
  • Helén Lagerkvist,
  • Maria Åberg Håkansson and
  • Jonas Hjelmgren

Bone conduction hearing implant systems (BCHIs) are established treatments for patients with conductive or mixed hearing loss or single-sided deafness when conventional hearing aids are unsuitable. This study evaluated the cost-effectiveness of the a...

  • Article
  • Open Access
246 Views
13 Pages

Evaluating [18F]-DCFPyL for Detecting Prostate Cancer Recurrence: A Cost–Consequence Comparison with Alternative PET Radiotracers in Spain

  • Tiago Matos,
  • Mrunmayee Godbole,
  • Rithvik Badinedi,
  • Madhusubramanian Muthukumar,
  • Marina Hodolic,
  • Nicolas Tchouen and
  • Anthony Berthon

Introduction: [18F]-DCFPyL (Piflufolastat [18F]) is a prostate-specific membrane antigen (PSMA)-targeted position emission tomography (PET) radiotracer for detecting the biochemical recurrence (BCR) of prostate cancer (PCa). This study evaluates its...

  • Article
  • Open Access
457 Views
12 Pages

Objectives: This study explores the feasibility and value of integrating structured patient input into the PICOS (Population, Intervention, Comparator, Outcome, Study design) scoping process for Joint Clinical Assessments under the EU Health Technolo...

  • Article
  • Open Access
526 Views
15 Pages

Development of a Performance Measurement Framework for European Health Technology Assessment: Stakeholder-Centric Key Performance Indicators Identified in a Delphi Approach by the European Access Academy

  • Elaine Julian,
  • Nicolas S. H. Xander,
  • Konstantina Boumaki,
  • Maria João Garcia,
  • Evelina Jahimovica,
  • Joséphine Mosset-Keane,
  • Monica Hildegard Otto,
  • Mira Pavlovic,
  • Giovanna Scroccaro and
  • Jörg Ruof
  • + 11 authors

Background: The objective of this work was to support the implementation of the European Health Technology Assessment Regulation (EU HTAR) and optimize performance of the evolving EU HTA system. Therefore, an inclusive multi-stakeholder framework of...

  • Communication
  • Open Access
340 Views
8 Pages

This perspective provides an in-depth analysis of the role and tasks of Notified Bodies (NBs) under the Medical Device Regulation (MDR) and In Vitro Diagnostic Regulation (IVDR). It explores the conformity assessment process and highlights typical is...

  • Article
  • Open Access
619 Views
15 Pages

European Joint Clinical Assessment PICO Scoping Process: Analysis of Current Approaches and Recommendations

  • Kalpana D’Oca,
  • Eline Darquennes,
  • Chloé Garrigues,
  • Aristeidis Draganigos and
  • Natalie Steck

The PICO framework determines the scope of the Joint Clinical Assessment (JCA) under the EU HTA Regulation (EU HTAR), with PICO consolidation being a critical final step of the scoping process. Due to limited clarity on how consolidation works in pra...

  • Article
  • Open Access
692 Views
21 Pages

Overcoming Patient Access Barriers in Complex Conditions: Lessons from Schizophrenia for Broader Healthcare Applications

  • Saartje Burgmans,
  • Anne Rieper Hald,
  • Sayagi Tina Markandaier,
  • Nicolas Hall,
  • Rafael Loiseau,
  • Xandra Lie and
  • Bregt Kappelhoff

Patient access to innovative care for complex conditions like schizophrenia remains limited by systemic, clinical and policy-level barriers. Cognitive impairment associated with schizophrenia (CIAS) illustrates how critical symptom domains are often...

  • Article
  • Open Access
358 Views
15 Pages

Background: Interactions between healthcare professionals and medical technology companies on social media are central to understanding how variations in knowledge spillover and innovation performance vary. Aim: This study investigates how social med...

  • Perspective
  • Open Access
843 Views
16 Pages

In the process of determining whether a health technology should be covered by healthcare systems, patients and their representatives were initially excluded from both evaluations and decision-making. In Europe, direct dialogue between patient organi...

  • Article
  • Open Access
583 Views
16 Pages

The Pharmaceutical Innovativeness Index: Supporting Value-Based Economic Regulation of Innovative Medicines

  • Ludmila Peres Gargano,
  • Marcus Carvalho Borin,
  • Wallace Mateus Prata,
  • Juliana Alvares-Teodoro,
  • Francisco de Assis Acurcio,
  • Roberto F. Iunes and
  • Augusto Afonso Guerra

The regulation of new medicine prices must balance financial sustainability with equitable access to innovation. Value-Based Pricing (VBP) strategies seek to align drug prices with their clinical and societal impact. The Pharmaceutical Innovativeness...

  • Systematic Review
  • Open Access
844 Views
15 Pages

Hard-to-heal wounds are a major burden to healthcare systems. Electrical stimulation therapy (EST) is known to improve clinical outcomes, but cost-effectiveness analysis is lacking. The aim was to explore the cost-effectiveness of EST with standard o...

  • Systematic Review
  • Open Access
1,194 Views
14 Pages

Network Meta-Analysis of Bevacizumab Gamma Versus Competing Interventions for Treating Neovascular Age-Related Macular Degeneration in the United Kingdom

  • Maria Lorenzi,
  • Stephen Ebohon,
  • Jennifer Kissner,
  • Jedd Comiskey,
  • Mayke Paap,
  • Christine Bouchet,
  • Andy Garnham and
  • Erika Wissinger

This study aimed to determine the relative efficacy of bevacizumab gamma (an ophthalmic formulation of bevacizumab) versus alternative interventions relevant to the treatment of neovascular age-related macular degeneration (nAMD) in the United Kingdo...

  • Article
  • Open Access
411 Views
10 Pages

Objective: This confirmatory survey aimed to verify the criterion-related validity and reliability of the final version of the Medical Doctors’ Work-Related Quality of Life Questionnaire (WQMD-9), following partial revision of its content. This...

  • Article
  • Open Access
1,508 Views
23 Pages

Patient Perspectives on Health Insurance Design: A Mixed-Methods Analysis

  • Bridget Doherty,
  • Kimberly Hooks,
  • Ulrich Neumann,
  • Wesley Peters,
  • Steven Zona and
  • Lisa Shea

There remains a persistent lack of patient-centered evidence on insurance reform and real-world experiences of patients with chronic disease. This study gathered insights around insurance design from chronic disease beneficiaries. This mixed-methods...

  • Article
  • Open Access
795 Views
14 Pages

The Impact of Copay Accumulators and Maximizers on Treatment Patterns, Adherence, and Costs Among Patients with Major Depressive and Bipolar Disorders Treated with Branded Therapies

  • Onur Baser,
  • Katarzyna Rodchenko,
  • Heidi C. Waters,
  • Matthew Sullivan,
  • Lixuan Wu,
  • Shuangrui Chen,
  • Madeline Shurtleff,
  • Cynthia Bigley and
  • Rashmi Patel

Copay accumulator (CA) and copay maximizer (CM) programs in the United States, which prevent manufacturer copay assistance from counting toward deductibles or out-of-pocket (OOP) maximums, are increasingly used, raising concerns about costs and outco...

  • Article
  • Open Access
880 Views
21 Pages

Background: Stakeholders’ perception plays a crucial role in shaping pharmaceutical strategies. Stakeholders are groups interested in pharmaceutical companies’ success and outcomes. Stakeholders’ perceptions are multifaceted and imp...

  • Article
  • Open Access
1,245 Views
24 Pages

A Data-Driven Approach for Estimating Type 2 Diabetes-Related Costs in Greece

  • Elisavet Nika,
  • Thomas Tsiampalis,
  • Athanasios Sachlas,
  • Evangelos Liberopoulos,
  • Sotirios Bersimis and
  • Dimitrios Georgakellos

Type 2 diabetes (T2D) constitutes a major health problem, reaching alarming rates over the last decades, especially due to contemporary lifestyle and associated obesogenic environments, as well as the aging population. Diabetes not only causes social...

  • Opinion
  • Open Access
1,750 Views
11 Pages

The introduction of the European Union (EU) Joint Clinical Assessment (JCA) under Regulation (EU) 2021/2282 marks a transformative step in harmonizing health technology assessments (HTAs) across EU member states. This article explores the implication...

  • Article
  • Open Access
1,037 Views
16 Pages

Access to home- and community-based services (HCBSs) varies substantially between states. Yet, it is unknown how state-level policies and administrative factors impact consumer-reported unmet service needs, an important indicator of HCBS access and q...

  • Opinion
  • Open Access
846 Views
14 Pages

Vaccination has resulted in substantial public health benefits for human populations worldwide since it was first introduced more than a century ago. This article presents an overview of the history of vaccine development, its implementation, and pri...

  • Article
  • Open Access
1,042 Views
12 Pages

Long-term intravenous therapies often necessitate the use of peripherally inserted central catheters (PICCs). Antimicrobial-coated PICCs have been introduced to minimize central line-associated bloodstream infections (CLABSIs). A decision-analytic co...

  • Review
  • Open Access
1 Citations
1,844 Views
25 Pages

Wound infection significantly hinders the healing process. Clinical signs and symptoms (CSS) of infection are used to assess the presence of infection and guide whether to intervene. However, CSS may not be dependable, lacking sensitivity and specifi...

  • Opinion
  • Open Access
1,152 Views
6 Pages

Shaping the Future of HTA in Italy: Insights from the Italian Health Policy Forum

  • Paolo Sciattella,
  • Roberta Laurita,
  • Chiara Bini,
  • Eugenio Di Brino,
  • Dario Sacchini and
  • Giandomenico Nollo

The implementation of the European (EU) Health Technology Assessment (HTA) Regulation 2021/2282 (EU HTAR) offers many opportunities, aimed at harmonizing HTA procedures and improving access to innovations; it also represents a significant challenge f...

  • Article
  • Open Access
1 Citations
2,066 Views
19 Pages

Shaping the Future of DHT Assessment: Insights on Industry Challenges, Developer Needs, and a Harmonized, European HTA Framework

  • Fruzsina Mezei,
  • Emmanouil Tsiasiotis,
  • Michele Basile,
  • Ilaria Sciomenta,
  • Elena Maria Calosci,
  • Debora Antonini,
  • Adam Lukacs,
  • Rossella Di Bidino,
  • Americo Cicchetti and
  • Dario Sacchini

Introduction: Market access, pricing, and reimbursement of digital health technologies (DHTs) in Europe are significantly challenged by regulatory fragmentation and various assessment methodologies. Understanding the challenges and priorities of tech...

  • Perspective
  • Open Access
2,872 Views
13 Pages

Safe Staffing Standards for Pharmacy Technicians in Hospital Settings

  • Vítor Silva,
  • João José Joaquim,
  • Shane Desselle,
  • Samantha Quaye and
  • Cristiano Matos

Pharmacy technicians (PT) are vital to the efficient and safe operation of hospital pharmacy services, fulfilling a range of technical and clinical responsibilities that directly impact patient care. However, increasing healthcare demands have unders...

  • Article
  • Open Access
2,980 Views
13 Pages

Designing an accessible, financially viable healthcare system is a key challenge for society. The value-based healthcare (VBHC) strategic model aims to simultaneously improve the quality of healthcare and the efficiency of health systems. The aim of...

  • Article
  • Open Access
742 Views
11 Pages

Deploying Experienced Utility in Health Economic Evaluation: A Quantitative Study

  • Damien S. E. Broekharst,
  • Sjaak Bloem,
  • Robert J. Blomme,
  • Edward A. G. Groenland,
  • Patrick P. T. Jeurissen and
  • Michel van Agthoven

Background: Expected utility has been deployed in order to predict health behaviour in health economic evaluation. However, only limited variance in health behaviour is explained by this construct. This limited explained variance is often attributed...

  • Opinion
  • Open Access
941 Views
7 Pages

Gene therapies that induce the body to produce therapeutic anti-vascular endothelial growth factor (anti-VEGF) proteins are an emerging topic related to neovascular age-related macular degeneration (nAMD). Continuous delivery of anti-VEGF protein dir...

  • Article
  • Open Access
1 Citations
1,046 Views
15 Pages

Background: With the ongoing development of game-changing technologies, assessing healthcare provider burden is desirable. This requires developing and evaluating subjective outcome measures, but there is no single scale that measures this burden. We...

  • Article
  • Open Access
2,065 Views
10 Pages

Managed Entry Agreements for Pharmaceutical Products in Three Maghreb Countries: Payer and Supplier Perspectives

  • Hajer Dahmani,
  • Leila Achour,
  • Maghreb Research Group,
  • Mondher Toumi and
  • Ines Fradi

Our objective is to describe the experience and challenges of using Managed Entry Agreements (MEAs) in Algeria, Morocco, and Tunisia. We conducted online interviews with key decision-makers in Algeria, Morocco, and Tunisia between March 2021 and Dece...

  • Article
  • Open Access
1,489 Views
15 Pages

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, o...

  • Review
  • Open Access
2 Citations
2,085 Views
11 Pages

Patient involvement in health technology assessment (HTA) processes is increasingly recognized as pivotal for informed, equitable, and patient-relevant health care decision-making. With the implementation of Joint Scientific Consultations (JSCs) and...

  • Article
  • Open Access
1 Citations
1,373 Views
11 Pages

Pivotal Studies for Drugs About to Be Launched for Rare Diseases: Will They Better Support Health Technology Assessment and Market Access than in the Past?

  • Claudio Jommi,
  • Marzia Bonfanti,
  • Melissa Guardigni,
  • Andrea Aiello,
  • Andrea Marcellusi,
  • Pier Luigi Canonico,
  • Fulvio Luccini and
  • Chiara Lucchetti

The designs of clinical trials of drugs for rare diseases are challenged by health technology assessment organisations and payers. Phase II pivotal studies, single-arm or open-label designs, the extensive use of non-final endpoints, and the limited u...

  • Article
  • Open Access
2 Citations
5,503 Views
15 Pages

Physician Practice Affiliation Drives Site of Care Cost Differentials: An Opportunity to Reduce Healthcare Expenditures

  • Deepak A. Kapoor,
  • Mark Camel,
  • David Eagle,
  • Lauren C. Makhoul,
  • Justin Maroney,
  • Zhou Yang and
  • Paul Berggreen

The continued migration of physicians from independent practice to affiliation with larger entities has garnered significant scrutiny. These affiliation models include hospitals and health systems, payers and corporate entities, and management servic...

  • Article
  • Open Access
2 Citations
3,101 Views
19 Pages

Preparing for the EU HTA Regulation: Insights from the Dutch Perspective

  • Anne Willemsen,
  • Maureen Rutten-van Mölken,
  • Riam al Dulaimi,
  • Hedi Schelleman,
  • Wim Goettsch and
  • Lonneke Timmers

The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. Thi...

  • Article
  • Open Access
1,187 Views
11 Pages

In respiratory patients, limited adherence to and misuse of devices hinder the effectiveness of inhalation therapy. Switching inhalers for non-clinical reasons poses a risk of deterioration of respiratory disease and/or promotes poor adherence to the...

  • Editorial
  • Open Access
798 Views
4 Pages

EU-HTA Guidance for Clinical Validity: Misconceptions and Flawed Processes

  • Mondher Toumi,
  • Bruno Falissard,
  • Asma Jouini,
  • Samuel Aballéa,
  • Laurent Boyer and
  • Pascal Auquier

This review of the scope of the European Health Technology Assessment (EU HTA)’s guidance on clinical trial validity in its randomized controlled trials (RCTs) highlights several key issues that undermine its practical application and effective...

  • Article
  • Open Access
1 Citations
1,955 Views
21 Pages

The PICO Puzzle: Can Public Data Predict EU HTA Expectations for All EU Countries?

  • Karolin Eberle,
  • Lisa-Maria Hagemann,
  • Maria Katharina Schweitzer,
  • Martin Justl,
  • Jana Maurer,
  • Alexandra Carls and
  • Eva-Maria Reuter

With the European Union (EU) Health Technology Assessment (HTA) regulation, Joint Clinical Assessments (JCA) are now required for oncological and advanced therapy medicinal products. The JCA assessment scope is determined through the PICO framework (...

  • Perspective
  • Open Access
2 Citations
1,729 Views
9 Pages

Opportunities for and Challenges of Conducting Indirect Treatment Comparisons and Meta-Analyses for Vaccines in Post-EU HTA Regulation Era

  • Charlotte Graham,
  • Erin Barker,
  • Joe Moss,
  • Emily Gregg,
  • Rachael McCool,
  • Nathalie Largeron,
  • Mélanie Trichard,
  • José Bartelt-Hofer and
  • Maribel Tribaldos

The dynamic nature of infectious diseases introduces inherent challenges to the design of vaccine clinical trials, which consequently makes vaccine indirect treatment comparisons (ITCs) and meta-analyses (MAs) more challenging compared with regular p...

  • Review
  • Open Access
1 Citations
1,682 Views
10 Pages

Background and Objective: Innovation is a key enabler of patient-centered care in cardiology, with new medical devices and digital health technologies offering the potential to improve outcomes and efficiency. However, the evaluation of these innovat...

  • Article
  • Open Access
1 Citations
1,384 Views
19 Pages

Exploring Trust in Health Insurers: Insights from Enrollees’ Perceptions and Experiences

  • Frank J. P. van der Hulst,
  • Sanne Huijgen,
  • Anne E. M. Brabers and
  • Judith D. de Jong

Managed competition is a key driver in healthcare systems in countries like Germany, Switzerland, and The Netherlands. Trust in health insurers is vital but currently low in The Netherlands. This may be due to perceptions regarding profit motives, ne...

  • Perspective
  • Open Access
4 Citations
4,093 Views
14 Pages

Health and Social Care Integration: Insights from International Implementation Cases

  • Ricardo Correia de Matos,
  • Generosa do Nascimento,
  • Adalberto Campos Fernandes and
  • Cristiano Matos

The integration of health and social care is increasingly recognized as essential to address population ageing, the rise in chronic diseases, and persistent health inequities. Across Europe, diverse models have been developed to improve service coord...

  • Opinion
  • Open Access
3 Citations
2,121 Views
15 Pages

The evolving landscape of Health Technology Assessment (HTA) in Europe, shaped by the implementation of the new EU HTA Regulation (HTAR), places an emphasis on engaging all stakeholders, including patients, in collaborative evidence generation. Yet i...

  • Editorial
  • Open Access
1,330 Views
5 Pages

The Art of Bridge Building: A Look at the European-Level Cooperation in HTA (EU-HTA)

  • Rui Santos Ivo,
  • Tiago Rodrigues,
  • Sara Couto and
  • Mariane Cossito

Health technology assessment (HTA) is a methodological and a scientific evidence-based process that allows competent authorities to determine the relative effectiveness of new or existing health technologies and to inform real-world decisions [...]

  • Article
  • Open Access
1,720 Views
12 Pages

Systemic therapy (ST) and transarterial radioembolization (TARE) are widely used treatments for advanced-stage hepatocellular carcinoma (HCC). This study quantified the significant variability in treatment costs for unresectable HCC from payer and pr...

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J. Mark. Access Health Policy - ISSN 2001-6689