Learnings to Kick-Start 2025: Health Equity

Published January 28, 2025

Health equity continues to be a hot topic in the life sciences industry. ISPOR EU sessions addressed several key questions surrounding the impact of health equity on HTA decision-making, the methodologies that should be employed, and the opportunities and challenges of incorporating health equity into health technology assessment (HTA).

Ahead of ISPOR EU, Trinity’s HTA Vision team analyzed the impact of health equity on HTA agency behavior across six recent pharmaceutical launches and seven countries: Australia, Canada, England, France, Germany, Italy and Spain. Our analysis, presented as a poster, found that NICE is the most consistent agency with regards to examining health equity and was the only agency to clearly state how health equity impacted recommendations. In three of six assessments, NICE stated that equity considerations had positively impacted patient access recommendations, either by including a wider population than supported by the cost-effectiveness analysis, or by having a positive impact on the decision. We found that outside of NICE, CDA and PBAC, no other HTA agencies mentioned health equity in their assessment of the six products included in the review.

ISPOR delegates called for greater clarity from HTA agencies around the type of health equity data welcomed in submissions. Currently HTA agencies provide relatively vague guidance to manufacturers around how to address health equity topics. PBAC, CDA, the CAPF (an advisory committee to AEMPS) and NICE invite manufacturers to discuss how their intervention may promote (or hinder) health equity, but they do not yet provide specific guidance around acceptable modeling methodologies or priority populations. Of the seven markets assessed, the relevant agencies in France, Italy and Germany did not publish any guidance or documentation regarding the provision of evidence related to health equity.

Discussions at ISPOR also highlighted the fact that manufacturers should consider the potential for policy makers to advocate for health equity-related value during the HTA process, in the way that patient representatives may address patient-related value. One industry leader made the point that, “It is key to find the point of alignment between policy and your data and then have the policy maker advocate during the HTA submission process. Patients have a voice to speak to the patient data and we need the policy maker to speak to the equity value.”

In conclusion, health equity considerations are beginning to impact HTA decision making. Multiple agencies are already referencing or considering health equity in their decision making; other agencies are likely to follow. However, direct evidence of health equity considerations and their impact on assessments is still relatively rare, and at the time of writing, medical benefit focused markets (such as DEU and FRA) have not yet taken health equity into consideration in their evaluations.

Author: Mary Fletcher-Louis and Matt O’Hara