Artificial Intelligence in Health Technology Assessment Submissions: A Targeted Review of Global Policy and Practice

Artificial intelligence (AI) has the potential of revolutionizing healthcare, including health technology assessments (HTAs). Although its application in HTA remains emerging, AI holds promise for enhancing evidence generation, dossier development, and review quality and efficiency. This study examines the landscape of AI/machine learning use and acceptance by HTA agencies.

A review of guidance documents, policy statements, and reports on AI use across HTA agencies in 17 countries (England, United States, Australia, Canada, France, Germany, Italy, Spain, Scotland, Belgium, The Netherlands, Sweden, Denmark, Finland, Norway, Japan, and Singapore), and European Network for Health Technology Assessment/Joint Clinical Assessment was conducted on October 1, 2025. A supplementary search of Embase, bibliographies of previous reviews, and gray literature was also completed.

Thirty-seven publications, including documents from 9 HTA agencies, were identified after screening 1309 abstracts. Among those providing guidance on AI/machine learning in HTA submissions, the National Institute for Health and Care Excellence, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Canada's Drug Agency (CDA-AMC), Haute Autorité de Santé, Norwegian Institute of Public Health, Belgium Health Care Knowledge Centre, and European Network for Health Technology Assessment referenced AI use in systematic literature reviews, data extraction, evidence synthesis, health economic modeling, real-world evidence, and internal operations, emphasizing human oversight, ethical governance, tool evaluation, and pilot testing. CDA-AMC has also developed an evaluation instrument for AI search tools to monitor and assess evolving technologies. Quebec's Institut National d'Excellence en Santé et Services Sociaux has created a GPT-4-based screening tool to assist study screening.

This review underscores the evolving yet inconsistent integration of AI into HTA submissions. The National Institute for Health and Care Excellence and CDA-AMC stand out as the only HTA agencies with a clear position statement with implementation strategy for AI.