The Health Economics Methods Advisory group (HEMA) is a new, independent group of health technology assessment agencies from the US, England and Canada that will work together to develop recommendations on adopting novel health economic methods to support decision making by health care systems. HEMA will also consider the need for modifications to current methods, the uncertainties in the application of new methods and suggestions for further research.
Nick Crabb, chief scientific officer at England’s NICE, explained that there is increased interest in the methods and value frameworks used in HTA because of the current “era of unprecedented innovation in medicines and health technologies.”
In response, “HEMA will provide an authoritative, international voice in key methodological areas where there are high levels of potential, controversy and challenge,” he told the Pink Sheet.
The ABPI, which represents the research-based industry in the UK, appears to welcome the group and told the Pink Sheet that it plans to engage with it. “We look forward to engaging in these important discussions on new HTA methods and approaches, ensuring their continuing evaluation remains sensitive to how they could impact patients and their access to medicines, both here in the UK, and internationally,” said Victoria Jordan, head of HTA and market access policy at the association.
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HEMA was launched in November and was set up to help HTA agencies to collaborate on independent assessments of methods for conducting health economics analyses. It is due to start work in the first quarter of 2025.
Unlike in Canada or England, though, the US participant in HEMA is not a government agency, but the independent non- profit Institute for Clinical and Economic Review (ICER). That different arrangement will likely reduce the impact that the initiative will have on reimbursement decisions in the United States.
According to ICER, HEMA could look at including dynamic efficiency and dynamic pricing in economic models, novel or non-traditional value in cost-effectiveness analysis and the integration of health equity considerations in quantitative analysis and deliberation.
Evolution in Methods
Methods development is already part of the work of HTA agencies. For example, ICER said it has been committed to developing its methods since its inception. “We re-examine our Value Assessment Framework every few years, convene a Methods Advisory Group several times per year, and solicit feedback on our analyses and processes from stakeholders across the health system, said Sarah Emond, ICER president and CEO.
HEMA will build on the international work that the three HTA agencies already do. “Through HEMA, [ICER] hope[s] to engage regularly with the international HTA community to discuss the advantages and drawbacks of new methods. And while implementation will vary across regions, this is an opportunity for the broader health economics community to critically examine and potentially pilot the feasibility of new approaches to HTA,” according to Emond.
Nicole Mittmann, chief scientist and vice president, scientific evidence, methodologies and resources at CDA-AMC, pointed to the importance of collaboration. She told the Pink Sheet that “together [the group] will critically examine and assess new economic methods and processes to support HTA and decision making.”
Multi-stakeholder Involvement
ICER is acting as the secretariat for HEMA, according to Dan Ollendorf, the agency’s chief scientific officer and director of health technology assessment methods and engagement. Crabb, will lead for NICE and Mittmann will lead for CDA-AMC.
HEMA’s work will be guided by a steering committee that will include representation from patient, payer and life science communities. There will also be a working group that will include representatives from each country to increase diversity in expertise and viewpoints.
According to Mittmann, HEMA “will work with patients, methodologists, and industry to provide recommendations to the HTA community regarding adoption of novel methods, modifications that might be required, uncertainties in methods application and suggestions for further research.”
Invitations to join the groups have gone out, but membership is not yet finalized. Members of the committee and working group will be published on ICER’s website in the future, said Ollendorf.
