Comments on A Conceptual Framework for Life-Cycle Health Technology Assessment

Abstract

An article by Kirwin et al. in Value in Health proposed a framework to be used for life-cycle Health Technology Assessment (HTA) processes with special emphasis on the need for de novo model development, the use of the “risk-based price” in decision-making, and research-oriented managed access (ROMA). However, we question if newly developed models for HTA are always required in routine practice given the high quality of models developed by sponsors, the low capacity of HTA agencies, and the unavailability of local data in some countries. Regarding the risk-based price, questions are raised on its methodology using value of information analysis as well as the applicability if its key concept, “payer risk tolerance” is poorly defined. This commentary discusses these aspects and addresses how they can be managed in order to complement the life-cycle approach.