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HTA criteria adopted in different models of public healthcare systems for orphan drugs: A scoping review

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  • Felippini, Arturo
  • Biglia, Luiza Vasconcelos
  • Lima, Tácio de Mendonça
  • Aguiar, Patricia Melo

Abstract

Access to drugs for rare diseases constitutes a challenge to healthcare systems, especially those with public funding. This study aimed to map and summarize the criteria used by HTA agencies in different healthcare systems to evaluate reimbursement recommendations for orphan drugs. A comprehensive literature search was performed on the databases PubMed, LILACS, Scopus, and Embase and the gray literature (Google Scholar and websites of HTA agencies). Publications addressing the criteria used by HTA agencies in countries with public healthcare systems when evaluating reimbursement recommendations for orphan drugs were included. This scoping review included 23 studies published between 2014 and 2023, mostly consisting of reviews of HTA reports, guidance documents, and original articles. The criteria were mapped from 19 countries and ranked within three models of healthcare systems (National Health System, National Health Insurance, and Social Health Insurance). All models shared concerns about unmet needs and disease nature. In addition, NHS countries (e.g., United Kingdom, Sweden, and Italy) prioritized innovation and system-level impact, while SHI countries (e.g., Germany, France, the Netherlands) usually valued budget impact and employed expedited evaluation processes. This review provides a comprehensive understanding of the general tendencies of each healthcare system model in establishing differentiated criteria to address the challenges posed by the limited evidence and investment in the field of rare diseases.

Suggested Citation

  • Felippini, Arturo & Biglia, Luiza Vasconcelos & Lima, Tácio de Mendonça & Aguiar, Patricia Melo, 2024. "HTA criteria adopted in different models of public healthcare systems for orphan drugs: A scoping review," Health Policy, Elsevier, vol. 144(C).
    • Handle: RePEc:eee:hepoli:v:144:y:2024:i:c:s0168851024000903
    DOI: 10.1016/j.healthpol.2024.105080
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    References listed on IDEAS

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    1. Cuadrado, Cristóbal & Crispi, Francisca & Libuy, Matías & Marchildon, Gregory & Cid, Camilo, 2019. "National Health Insurance: A conceptual framework from conflicting typologies," Health Policy, Elsevier, vol. 123(7), pages 621-629.
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