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Pre-reimbursement: early assessment for coverage decisions.

Nicole Grössmann1,2, Sarah Wolf3, Katharina Rosian3

  • 1Ludwig Boltzmann Institute for Health Technology Assessment, Garnisongasse 7/20, 1090, Vienna, Austria. Nicole.Groessmann@hta.lbg.ac.at.

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Summary

The Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) uses Horizon Scanning in Oncology (HSO) and Medical Extra-Leaguers (MELs) for early assessments. These programs aid coverage decisions, with healthcare system organization influencing outcomes.

Keywords:
Decision supportEarly assessmentHealth Technology AssessmentHealth technologiesReimbursement

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Area of Science:

  • Health Technology Assessment (HTA)
  • Oncology
  • Health Services Research

Background:

  • The Ludwig Boltzmann Institute for Health Technology Assessment (LBI-HTA) developed Horizon Scanning in Oncology (HSO) and Medical Extra-Leaguers (MELs) to support healthcare coverage decisions.
  • These programs focus on early assessments to inform policy and practice.

Purpose of the Study:

  • To outline the general processes and methodologies employed within the LBI-HTA's HSO and MELs programs.
  • To provide insights into the practical application of early HTA in healthcare decision-making.

Main Methods:

  • A narrative-descriptive synthesis of relevant literature was conducted.
  • The study focused on outlining general and LBI-HTA-specific processes and methods for early assessments.

Main Results:

  • The LBI-HTA has completed 79 HSO assessments (2009-2018) and 95 MELs (2008-2018).
  • Recent updates have incorporated methods to enhance European applicability of these assessment programs.

Conclusions:

  • Pre-coverage decisions rely heavily on the available evidence base.
  • The structure of the healthcare system and collaboration between decision-makers and HTA bodies significantly impact the effectiveness of early assessments.