18 July, 2019

Appraisal Panel member Dr Sally Lewis reflects on HTAi 2019

Road directions to the HTAi 2019 annual meeting.

The Health Technology Wales team recently attended the Health Technology Assessment international (HTAi) 2019 Annual Meeting in Cologne and were joined by Dr Sally Lewis, a General Practitioner and member of our Appraisal Panel.

Sally is also National Clinical Lead for Value-based and Prudent Healthcare, and attended the four-day conference alongside 1,200 health technology assessment (HTA) professionals.

In her own words, Sally reflected on her experience of the HTAi 2019 Annual Meeting:

“At this year’s HTA international conference in Cologne, I was asked to contribute as a panellist to the topic ‘How health technology assessments are evolving to support value-based healthcare.’

I began by highlighting what I think we are trying to achieve through getting the best value when adopting the use of medical devices. We’re attempting to provide evidence in order to improve outcomes for patients within the resources that we have available, improve safety in medical devices and spot problems early, as well as reduce unwarranted variation in uptake across a system.

These issues can broadly be divided into three categories:

  • Novel products that may be in high value, but there may also be a lack of data on their effectiveness.
  • Replacement products that are deemed to be better in value, e.g. lower cost, compared with current products that have a similar function.
  • Potential overuse (suboptimal positioning) of a cost-effective product which when used out of context has lower value.

The context in which an assessment is carried out was of great interest to me given the obvious push to harmonise HTA globally. I argued that this could give erroneous results if we did not consider impact, and therefore value, in terms of the local context, particularly in relation to pathway changes brought about through the adoption of diagnostic devices. I also think that it is insufficient for HTA to stop at adoption, particularly as there is often a lack of data at this point.

Post-adoption, we should be looking to generate and use real world evidence from patient outcome data that includes both condition-specific and global quality of life measures. There is a need for more research into robust methodology on how we can calculate quality-adjusted life-years (QALYs) from condition-specific tools to help us better assess value in the longer term.

This work will, I’m sure, accelerate over the next few years and HTAs are very well placed to drive this forward in partnership with industry. I’m sure this will be a hot topic for HTAi 2020 in China.”