Adaptive Health Technology Assessment - value and limitations to inform resource allocation in India

Health Technology Assessment (HTA) is an essential tool for transparent decision-making and prioritisation of resources routinely used in many high-income countries. The use of HTA in resource allocation is now gaining traction in several Low- and Middle-Income Countries too. India is one such country that has taken critical steps to integrate HTA into its policymaking framework. We explore the potential role of Adaptive (aHTA) as a screening measure and a more flexible approach to optimising the capacity of HTA. Adaptive HTA, as 'a structured approach to identify and conduct the optimised full HTA analysis', offers a pragmatic way to balance the need for swift decision-making with methodological rigour. We examined the value aHTA brings to decision-makers based on the Indian experiences in conducting aHTA and further discussed the challenges involved in its methodology and implementation. Institutionalising aHTA is proposed as both a tool for topic prioritisation and optimising the full HTA for timely decision-making, integrated within the broader HTA ecosystem in India. Given the evolving nature of aHTA methods and processes, we propose that there is a need to: standardise aHTA methodologies and develop reference cases which benchmark a set of guiding principles, methodological, and reporting standards.