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How Good Is Good Enough? A Simulation Study of Adaptive Health Technology Assessment.

Jamaica Roanne V Briones1, Peter Baker2, Wanrudee Isaranuwatchai3

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Summary
This summary is machine-generated.

Uncertainty in adaptive Health Technology Assessment (aHTA) impacts reimbursement decisions. The aHTA approach is suitable when cost-effectiveness ratios are clear, variability is low, and risks are modest.

Keywords:
adaptive HTAhealth technology assessmentpriority settingrapid HTAsimulation

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Area of Science:

  • Health Economics
  • Health Technology Assessment
  • Decision Analysis

Background:

  • Adaptive Health Technology Assessment (aHTA) involves evaluating healthcare interventions.
  • Uncertainty in aHTA can influence crucial reimbursement decisions.
  • Understanding factors contributing to this uncertainty is vital for accurate assessments.

Purpose of the Study:

  • To evaluate the impact of uncertainty in aHTA on reimbursement decisions.
  • To identify key factors contributing to uncertainty in aHTA.
  • To quantify the financial risks associated with incorrect reimbursement decisions.

Main Methods:

  • A simulation-based approach generated a distribution of aHTA Incremental Cost-Effectiveness Ratios (ICERs).
  • ICERs were adjusted for currency, inflation, and technology price.
  • Uncertainty was quantified by estimating the probability of wrong reimbursement decisions using willingness-to-pay (WTP) thresholds and a reference ICER from Thailand.

Main Results:

  • The probability of incorrect decisions decreased when aHTA ICERs were far from the WTP threshold.
  • Low variability in published ICERs, especially with similar methodologies, increased confidence.
  • Technology price adjustments reduced variability; modest disease burden and lower costs correlated with smaller financial risks.

Conclusions:

  • The aHTA approach is suitable when the ICER is clearly above or below the WTP threshold.
  • Low variability among published ICERs enhances confidence in aHTA findings.
  • Modest disease burden and financial risks are favorable conditions for aHTA suitability.