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Keywords = Joint Clinical Assessment (JCA)

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11 pages, 208 KB  
Review
Patient Involvement in Health Technology Assessments: Lessons for EU Joint Clinical Assessments
by Anne-Pierre Pickaert
J. Mark. Access Health Policy 2025, 13(3), 38; https://doi.org/10.3390/jmahp13030038 - 28 Jul 2025
Viewed by 608
Abstract
Patient involvement in health technology assessment (HTA) processes is increasingly recognized as pivotal for informed, equitable, and patient-relevant health care decision-making. With the implementation of Joint Scientific Consultations (JSCs) and Joint Clinical Assessments (JCAs) under Regulation (EU) 2021/2282, the European Union has a [...] Read more.
Patient involvement in health technology assessment (HTA) processes is increasingly recognized as pivotal for informed, equitable, and patient-relevant health care decision-making. With the implementation of Joint Scientific Consultations (JSCs) and Joint Clinical Assessments (JCAs) under Regulation (EU) 2021/2282, the European Union has a unique opportunity to design harmonized mechanisms that reflect best practices from established HTA systems. This article, drawing on the Acute Leukemia Advocates Network (ALAN)’s comparative analysis of HTA practices across seven countries (Canada, England, Scotland, France, Germany, Spain, and Italy), examines how current patient involvement processes can inform the JCA framework. It identifies opportunities to replicate effective practices and proposes strategies to embed patient voices meaningfully into the JCA process. By prioritizing robust and inclusive patient involvement, the EU can establish a global benchmark for impactful and consistent HTA processes. By leveraging lessons from international HTA systems and prioritizing clear frameworks, early involvement, and capacity building, the EU can set a global standard for meaningful patient participation in HTA processes. ALAN is an independent global network of patient organizations dedicated to improving outcomes for patients with acute leukemia. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
19 pages, 424 KB  
Article
Preparing for the EU HTA Regulation: Insights from the Dutch Perspective
by Anne Willemsen, Maureen Rutten-van Mölken, Riam al Dulaimi, Hedi Schelleman, Wim Goettsch and Lonneke Timmers
J. Mark. Access Health Policy 2025, 13(3), 35; https://doi.org/10.3390/jmahp13030035 - 24 Jul 2025
Viewed by 1476
Abstract
The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. This may require adaptations at the [...] Read more.
The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. This may require adaptations at the national level. This paper describes the anticipated changes to the Dutch national HTA process and how the Dutch National Health Care Institute (Zorginstituut Nederland, ZIN) prepared for this, because sharing experience between Member States can be of general interest for future expansion of the EU HTAR. ZIN’s implementation activities were facilitated by a project-governance structure and by a continuous gap analysis of the current national assessment and appraisal process of medicinal products, resulting in a concrete action plan. The implementation of the HTAR has two major implications for ZIN’s HTA process, namely that the scoping phase starts much earlier and that the JCA report is the starting point for the national assessment. Gaps, challenges and issues were identified in the categories: information and knowledge, IT and template, communication and stakeholder engagement, capacity and resources, and financial aspects. Based on a thorough and well-defined implementation plan, ZIN is ready to implement the HTAR in national HTA processes and to take on (co-)assessor roles for JCA of medicinal products in 2025. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
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21 pages, 615 KB  
Article
The PICO Puzzle: Can Public Data Predict EU HTA Expectations for All EU Countries?
by Karolin Eberle, Lisa-Maria Hagemann, Maria Katharina Schweitzer, Martin Justl, Jana Maurer, Alexandra Carls and Eva-Maria Reuter
J. Mark. Access Health Policy 2025, 13(3), 32; https://doi.org/10.3390/jmahp13030032 - 26 Jun 2025
Viewed by 695
Abstract
With the European Union (EU) Health Technology Assessment (HTA) regulation, Joint Clinical Assessments (JCA) are now required for oncological and advanced therapy medicinal products. The JCA assessment scope is determined through the PICO framework (Population, Intervention, Comparator, Outcome). Given the tight JCA timelines, [...] Read more.
With the European Union (EU) Health Technology Assessment (HTA) regulation, Joint Clinical Assessments (JCA) are now required for oncological and advanced therapy medicinal products. The JCA assessment scope is determined through the PICO framework (Population, Intervention, Comparator, Outcome). Given the tight JCA timelines, Health Technology Developers (HTD) must anticipate PICO elements early to prepare dossiers effectively. This study investigates whether PICO can be predicted across EU member states using publicly available information. A systematic literature review was conducted to identify relevant peer-reviewed articles. Additionally, an extensive search of publicly available HTA documents, including reports, methodological guidelines, submission templates, and market access information was performed across 29 European countries. Relevant information for PICO anticipation was extracted. For many member states, a wealth of relevant information is publicly accessible: 66% have HTA reports publicly available, 79% have HTA methodological guidelines, 69% have dossier templates, and 100% have market access status lists. Between countries, the requirements for population and outcomes are largely aligned, making comparator the central element in PICO anticipation. PICO can be anticipated reliably based on public information. HTDs must be prepared to adjust their strategies as national procedures adapt, ensuring alignment with both current and emerging EU and national requirements. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
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9 pages, 1004 KB  
Perspective
Opportunities for and Challenges of Conducting Indirect Treatment Comparisons and Meta-Analyses for Vaccines in Post-EU HTA Regulation Era
by Charlotte Graham, Erin Barker, Joe Moss, Emily Gregg, Rachael McCool, Nathalie Largeron, Mélanie Trichard, José Bartelt-Hofer and Maribel Tribaldos
J. Mark. Access Health Policy 2025, 13(2), 31; https://doi.org/10.3390/jmahp13020031 - 11 Jun 2025
Viewed by 961
Abstract
The dynamic nature of infectious diseases introduces inherent challenges to the design of vaccine clinical trials, which consequently makes vaccine indirect treatment comparisons (ITCs) and meta-analyses (MAs) more challenging compared with regular pharmaceuticals. However, comparisons of efficacy and safety between vaccines are being [...] Read more.
The dynamic nature of infectious diseases introduces inherent challenges to the design of vaccine clinical trials, which consequently makes vaccine indirect treatment comparisons (ITCs) and meta-analyses (MAs) more challenging compared with regular pharmaceuticals. However, comparisons of efficacy and safety between vaccines are being frequently required in vaccine decision making due to a low number of head-to-head clinical trials in the vaccine landscape. The introduction of the European Union Health Technology Assessment (HTA) Regulation (EU HTAR) aims to harmonize HTA efforts across Europe. However, the EU HTAR could also escalate existing challenges for conducting vaccine MAs and ITCs. Such challenges include generating efficacy evidence in time for Joint Clinical Assessment (JCA), incorporating high levels of heterogeneity due to infectious disease-specific characteristics, and tackling a high number of PICOs per submission—likely driven by heterogeneity in the available data and differences in national vaccine calendars. Opportunities to tackle these challenges include introducing a stepwise approach to vaccine assessment in JCA, best-practice recommendations for conducting/interpreting vaccine MAs and ITCs, and condensing the number of PICOs to create larger ‘catch-all’ ITC networks. This perspective article explores these challenges and opportunities further. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
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9 pages, 195 KB  
Article
ARM’s Perspective on the First Joint Clinical Assessments for ATMPs: Challenges and Opportunities on the Path Ahead
by Paolo Morgese, Stephen Majors and Dilip Patel
J. Mark. Access Health Policy 2025, 13(2), 14; https://doi.org/10.3390/jmahp13020014 - 3 Apr 2025
Viewed by 757
Abstract
Advanced Therapy Medicinal Products (ATMPs) are revolutionising modern medicine. By addressing the root cause rather than the symptoms of disease, ATMPs hold the promise of long-lasting benefits or even cures for severe, genetic, and rare diseases—including rare cancers—for patients with few or no [...] Read more.
Advanced Therapy Medicinal Products (ATMPs) are revolutionising modern medicine. By addressing the root cause rather than the symptoms of disease, ATMPs hold the promise of long-lasting benefits or even cures for severe, genetic, and rare diseases—including rare cancers—for patients with few or no viable treatment options. At the same time, the inherent complexities of ATMPs pose challenges to traditional HTA frameworks. Unlike conventional treatments, ATMPs are often one-time therapies with a high magnitude of effect. However, their long-term durability remains uncertain at launch. The Joint Clinical Assessment (JCA), under the EU’s Health Technology Assessment (HTA) Regulation, represents a once-in-a-generation opportunity to consolidate the strengths of national HTA processes into a unified framework that accounts for the specificities of ATMPs and streamlines decision-making, cementing Europe’s position as a pioneer in innovative HTA approaches. While concerns remain regarding the suitability of current JCA methodologies for ATMPs, the HTA Regulation continues to bring the HTA ecosystem closer together, with numerous benefits already emerging from EU-wide collaboration on JCAs. This article outlines the HTA challenges posed for and by ATMPs, and ARM’s perspective on the JCA’s implementation. A ‘fit for purpose’ JCA holds the promise to unlocking these therapies’ benefits for individuals across Europe. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
12 pages, 763 KB  
Article
Ensuring the Efficiency and Effectiveness of Joint Clinical Assessment in National HTA Decision-Making: Insights from the 2024 CIRS Multi-Stakeholder Workshop
by Ting Wang and Neil McAuslane
J. Mark. Access Health Policy 2025, 13(1), 9; https://doi.org/10.3390/jmahp13010009 - 3 Mar 2025
Viewed by 848
Abstract
Background: This study explored the readiness and strategic considerations of companies and key stakeholders for the implementation of the Joint Clinical Assessment (JCA) under the European Health Technology Assessment Regulation (HTAR). It examined the implications of the JCA process for jurisdictional submission strategies, [...] Read more.
Background: This study explored the readiness and strategic considerations of companies and key stakeholders for the implementation of the Joint Clinical Assessment (JCA) under the European Health Technology Assessment Regulation (HTAR). It examined the implications of the JCA process for jurisdictional submission strategies, and decision-making across Europe. The study aimed at identifying key measures for an efficient and effective JCA process to enable national rollout. Methods: A survey was conducted with international pharmaceutical companies, followed by a multi-stakeholder workshop that expanded on the findings. The survey and workshop focused on key areas such as time to market, submission strategies, and the role of JCA in national decision-making processes. Descriptive and qualitative analyses were performed to identify recommendations for measuring and improving the JCA process. Results: 13 companies responded to the survey, respondents were generally prepared for the JCA process (readiness rated 6–7/10), but concerns persist about timeline uncertainties and timely JCA report delivery. In the short term, success for the HTAR from the company perspective is measured by positive recommendations across EU jurisdictions. Long term, the focus shifts to aligning HTA methodologies and evidence requirements across the EU. Establishing metrics to assess the efficiency and effectiveness of the JCA is a key step in the HTAR’s ongoing learning journey. To enhance the efficiency of the JCA process, a list of metrics is recommended for continuous improvement, as well as establishing training programs to strengthen member states’ capabilities, fostering open dialog for sharing technology-specific insights, and creating open-source tools to support companies. Additionally, research should be conducted to understand agencies’ expectations of the JCA and how they will use its reports, grouping agencies by archetype to identify trends. A key recommendation is the development of a product-based scorecard to evaluate JCA submissions and reviews from various perspectives, ensuring the process meets stakeholders’ needs and can be effectively utilized in national decision-making. Conclusions: The JCA process offers a significant opportunity to streamline HTA decision-making across Europe. This study highlights several key measures and consideration for its successful rollout, including the need for clearer communication about the role of JCA in national decisions, measurement of rollout time components, and the development of quality evaluation frameworks. A collaborative, iterative approach, where stakeholders continually refine the system, will be essential for its effectiveness. Addressing these challenges will enable the JCA to enhance efficiency, consistency, and ultimately improve access to treatments for patients. Full article
(This article belongs to the Collection European Health Technology Assessment (EU HTA))
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5 pages, 422 KB  
Opinion
EU HTA Regulation and Joint Clinical Assessment—Threat or Opportunity?
by Volker Schuster
J. Mark. Access Health Policy 2024, 12(2), 100-104; https://doi.org/10.3390/jmahp12020008 - 13 May 2024
Cited by 8 | Viewed by 2209
Abstract
The vision of a unified European HTA is by no means a new endeavor. At its core are the publicly declared ambitions to harmonize assessments of clinical data within the EU and avoid the duplication of efforts. Not surprisingly, these ambitions are publicly [...] Read more.
The vision of a unified European HTA is by no means a new endeavor. At its core are the publicly declared ambitions to harmonize assessments of clinical data within the EU and avoid the duplication of efforts. Not surprisingly, these ambitions are publicly announced to be motivating the new 2022 EU HTA regulation. However, industry experts typically see more of a risk for additional bureaucracy resulting in delays, further scrutiny, and one additional EU (clinical) dossier to submit on top of all national HTA dossiers, which could be considered a duplication of effort and therefore counterproductive. Regardless of how the details of the process will be defined and how the entire process will work in practice, we can be sure that EU officials will refer to the EU HTA and Joint Clinical Assessment (JCA) in particular as a learning system. The purpose of this article is to take a closer look at the new EU HTA regulation and analyze threats and opportunities for manufacturers and what the resulting opportunities and threats will be at the affiliate level throughout the EU. Full article
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9 pages, 940 KB  
Article
The Correlation amongst Salty Taste Preference and Overactive Bladder Symptoms in Female Individuals
by Jin-Won Noh, Kyoung-Beom Kim, Jae Heon Kim and Young Dae Kwon
Int. J. Environ. Res. Public Health 2021, 18(2), 518; https://doi.org/10.3390/ijerph18020518 - 10 Jan 2021
Viewed by 2241
Abstract
Sodium intake could have an indirect effect on storage symptoms as it is an established fact that it has a correlation to hypertension (HTN). However, clinical support for the correlation of sodium intake to STORAGE symptom remains scarce. Therefore, the present work sought [...] Read more.
Sodium intake could have an indirect effect on storage symptoms as it is an established fact that it has a correlation to hypertension (HTN). However, clinical support for the correlation of sodium intake to STORAGE symptom remains scarce. Therefore, the present work sought to determine how sodium intake and OAB symptom seriousness were correlated in female individuals based on a cross-sectional research design. Data from 115,578 respondents chosen from 228,921 individuals enrolled in the Korean Community Health Survey (KCHS) were subjected to cross-sectional analysis. The correlation amongst sodium intake and STORAGE symptom was assessed on the basis of estimates of the incidence rate ratio (IRR) with 95% confidence interval (CI). Furthermore, joint correspondence analysis (JCA) was conducted to investigate how a predilection for salty taste was associated with several factors, including STORAGE symptom, socio-economic factors, comorbidities, and dietary habits. By comparison to respondents indicating a neutral predilection for salty taste, those who indicated a predilection for bland and salty taste were 7.1% (IRR = 1.071, p < 0.001, 95% CI = 1.045–1.097) and 20.5% (IRR = 1.205, p < 0.001, 95% CI = 1.177–1.234) more probable to experience severe STORAGE symptom, within an adjusted model with multiple variables. JCA confirmed the existence of a correlation between predilection for salty taste and STORAGE symptom. A close correlation was established to exist between predilection for salty taste and lower urinary tract symptoms (LUTS), such as voiding and storage symptoms and nocturia. Moreover, sodium intake was found to be a risk factor for LUTS seriousness in both excessive and deficient amount. Full article
(This article belongs to the Section Women's Health)
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