HTA and CER: What US Payers Can Learn From Their UK Peers
By: John Doyle, DrPH, MPH | September 16, 2014
In the context of assessing risk and benefit, one area that warrants further examination is comparative effectiveness research (CER). As private payers and quasi-governmental agencies in the U.S. rush to embrace CER, some insight can be gleaned from looking at how U.K payers perceive health technology assessments (HTA)— a different yet related tool to evaluate real-world effectiveness and risk profiles of products versus standardized therapy.
In Quintiles’ recent survey of U.S. and U.K payers and other industry stakeholders, we found UK payers are less impressed by HTA than US payers are of CER on a number of different measures.
Less than a third of UK payers feel that HTA perform very or extremely well on improving patient outcomes, and less than a quarter feel that HTA do a good job of ensuring that the right patient population receives the right medication. These findings contrast sharply with the perception of CER initiatives among U.S. payers, the majority of whom say that CER performs well on both measures.
What we can interpret from these results is that although the US is moving in the right direction in conducting this type of real world research, we must be guarded in our optimism with respect to the commercial and real world implications of CER. Given that the U.K. has more than 10 years experience in putting HTA into practice, U.K. payer skepticism as to their utility should be seen as a learning opportunity for U.S.-based organizations looking to conduct CER initiatives.
CER methods should not only address technical aspects of study design, subject selection, analytic techniques, and process and outcome measurement, but also address such weighty issues as ethical, humanistic and feasibility considerations related to real-world research. And it is apparent that communication of research will play a vital role to ensuring long term impact.
To see the full results of the survey, download the 2012 New Health Report.