In South Korea, health technology assessment (HTA) evaluates the safety, efficacy, and cost effectiveness of technologies reimbursed by national health insurance. The National Evidence-Based Healthcare Collaborating Agency (NECA) engages the public and patients in HTA to enhance transparency and relevance. This study examined intra-articular corticosteroid injections (IACS) for knee osteoarthritis and radiofrequency ablation (RFA) for thyroid nodules to illustrate the role of diverse stakeholder input in decision-making.

Public Participation for IACS: IACS is a familiar treatment for knee osteoarthritis in Korea and has been used extensively for decades. To capture public perceptions, a structured survey was conducted to identify concerns about treatment frequency, safety, and efficacy. Findings were synthesized with systematic reviews to create public-friendly materials such as infographics, videos, and social media content.

Patient Participation for RFA: RFA, a non-reimbursed procedure for thyroid nodules, required direct input from patients to assess its value. Semi-structured interviews with RFA recipients explored their decision-making priorities, such as symptom relief, cosmetic concerns, and post-procedure recovery. These insights informed the evaluation framework for RFA in HTA.

Public surveys on IACS emphasized the need for clearer guidelines about dosing and safety, particularly for repeat injections. Systematic reviews showed limited evidence on long-term adverse effects, prompting further research. Educational materials enhanced public awareness of risks and benefits, supporting informed choices.

Interviews with patients who had received RFA revealed unique challenges and shared concerns specific to thyroid conditions, such as post-procedure discomfort and symptom management priorities. These insights, including preferences for nodule size reduction and recurrence rates, aligned with expert-defined outcome priorities, validating patient-reported outcomes in HTA. These findings led to a conditional recommendation balancing clinical value and misuse prevention.

Integrating public and patient voices into HTA strengthens evidence generation and fosters trust in health policy decisions. By addressing diverse stakeholder concerns, NECA aims to expand engagement mechanisms throughout the HTA life cycle. This dual-participation model demonstrated a scalable framework for global HTA practices, promoting inclusivity and transparency in healthcare decision-making.

There is a lack of family-based psychosocial support interventions in palliative care when a parent of children or youths has a life-threatening illness. One intervention that has shown positive effects is the family talk intervention (FTI). This study aimed to describe the influence of contextual factors on FTI sustainability, as perceived by healthcare professionals (HCPs), after a median of 18 months of implementation in clinical practice in cancer and palliative care when a parent of children or youths has a life-threatening illness.

Focus groups and individual interviews were conducted with 15 HCPs working with FTI. Data were analyzed using conventional qualitative content analysis.

HCPs identified contextual factors that facilitated or hindered the use of FTI. The analysis resulted in 3 categories, Trying to prioritize FTI and coordinate families in a complex context is challenging, Working alone without FTI-educated colleagues hampers sustainability, the satisfaction of seeing families become stronger contributes to a receptiveness for change.

This study shows that organizational support and resources, alongside the individual’s facilitating factors, such as receptiveness for change, are crucial for sustainability after the initial implementation. Witnessing a positive impact is motivational and also supports the sustainability of an intervention despite contextual constraints.

The establishment of health technology assessment (HTA) in health systems is essential for their sustainability. In Brazil, CONITEC was legally established in 2011, and its first reports were published in 2012. CONITEC has consistently contributed to maintaining evidence-based access to technologies in Brazil’s Unified Health System (SUS).

This study aimed to summarize and understand the characteristics of submitted requests such as type of technology, tendencies, and deliberation outcomes. All reports for technologies submitted to CONITEC that were available on the official website, published from 2012 to November 2024, were included. Data of interest included: year of assessment, nature of the request (inclusion, disinvestment, or expansion of use to subgroups not already indicated for the technology), type of technology (medication, procedure, or health product), and medical field (e.g., oncology, rheumatology). Absolute and relative frequencies as well as temporal analyses were performed on the extracted data.

From a total of 1,084 (average of 90.3 per year) identified reports, 836 were related to medications, 173 to products, and 75 to procedures. Inclusion, disinvestment, and expansion accounted for 928 (85.6%), 89 (8.2%), and 63 (5.8%) of the reports, respectively. A growth trend in the number of reports per year was not observed, despite a peak in 2021 (115 assessments). This peak was due to a concentration of reports on disinvestment, which represented 31.3 percent of the reports conducted that year. The three most represented medical fields were infectiology (14.2%), oncology (11.5%), and hematology (7.2%).

The large number of HTA reports assessed by CONITEC showed the potential of the Brazilian SUS to promptly respond to health needs. Further studies may reveal why incorporation and disinvestment are the most frequently submitted requests. Monitoring requests can help understand the dynamics of HTA, which is crucial for system management and sustainability.

One of the main objectives of health systems should be to try to reduce inequality gaps. America is the most unequal region in the world. Until recent years, equity continued not to be part of standard health technology assessment (HTA) reports of the main world agencies. We conducted a survey of member institutions of the Health Technology Assessment Network of the Americas (RedETSA) and the Pan American Health Organization (PAHO) to explore the approaches used to measure equity across American countries.

A survey was conducted addressing equity in HTA in the institutions that make up RedETSA. It was sent to members of the technical teams of the institutions that are part of this network. Through a semi-open questionnaire sent in electronic format, we searched to identify which organizations are addressing equity in HTA, as well as perceptions and personal opinions about its importance and the level of training in this regard. Positive case examples were requested. A scoping review of worldwide methods related to equity-HTA was conducted.

Responses were obtained from 39 individuals working in 34 institutions in 14 countries. All those who responded belong to the technical teams of the institutions that are members of RedETSA. Of these respondents, 97.4 percent consider that the potential impact on equity of new health technologies should always be evaluated in HTA reports, but only 10.8 percent respond that they always do it in their agencies. The approaches used by these institutions were heterogeneous. In order to organize the various proposals that were identified to address equity in HTA, a graph was prepared where the different tools and approaches were classified.

The results of our survey of HTA organizations in the region coincided with global publications, such as the 2015 review of 121 HTA world agencies, which identified that the approach to equity is not systematic; it is performed in few cases and with different methodological approaches. The scoping review identified a wide range of proposed methodological approaches to measure equity.

Quantum technologies, driven by principles of quantum mechanics like superposition and entanglement, have shown transformative potential in health and medicine. However, the understanding of these technologies in early to late stages of development is limited. This study aimed to investigate the emerging applications of quantum technologies in health care, with a focus on quantum computing, diagnostics, and therapeutics.

Horizon scanning researchers, in collaboration with information specialists and with steering from subject matter experts at National Health Service England, developed search strategies for identifying relevant emerging and established quantum applications in healthcare domains such as drug design, personalized medicine, diagnosis assistance, and treatment or interventions. We conducted a comprehensive review of this landscape by analyzing data from clinical trials, published literature, and soft intelligence sources. Primary and secondary sources were reviewed systematically using a combination of traditional methods and the Innovation Observatory’s in-house semi-automated Search Companion for Advanced News Article Retrieval (SCANAR) tool to capture non-traditional soft intelligence sources.

The scan identified 116 quantum technologies in health care, with magnetoencephalography (MEG), quantum dots, and superconducting quantum interference devices (SQUIDs) being the most frequently used for brain mapping, imaging, and cardiac diagnostics. Over half (54%) of these technologies assist in diagnosis, while others are used in drug design (15%), treatment (15%), and precision medicine (13%). Quantum computing applications (28%) and quantum dots (24%) were the most common applications identified. Non-commercial trials dominated (88%), reflecting a focus on advancing care. Additionally, 27 percent of the technologies incorporate artificial intelligence, mainly for personalized medicine and imaging diagnosis.

Quantum technologies in health care are advancing areas of diagnostics, personalized medicine, and therapeutics. Diagnostics are the most popular area, most frequently using technologies such as MEG, SQUIDs, and quantum dots. Quantum computing algorithms accelerate drug discovery and precision medicine. Although promising, integrating quantum technologies into health care faces challenges in infrastructure demands and regulatory frameworks, and requires professional training in quantum literacy.

The Shared Learning model redefines patient engagement in health technology assessment (HTA) by combining immersion, knowledge sharing, and network expansion. Through flexible programs like Patient Voice Initiative (PVI) Patient Partners, it empowers advocates to deepen their understanding of HTA processes and disseminate insights broadly. This innovative, scalable approach ensures patient voices are central to decision-making, fostering informed contributions and addressing the challenges of rapidly evolving health technologies.

The Shared Learning model piloted by the PVI supported three patient advocates through a structured immersion in HTA processes. Advocates engaged directly in HTA discussions, meetings, and consultations, attending the HTAi Annual Meeting 2024 for deeper insights and networking. The model emphasized peer knowledge dissemination through webinars, workshops, and community forums, creating a ripple effect of shared learning. Advocates reflected on their experiences, identifying insights to benefit broader patient networks. This approach combined immersive learning, knowledge-building, and capacity expansion, fostering both vertical engagement with HTA stakeholders and horizontal knowledge-sharing within patient communities.

The Shared Learning pilot demonstrated success in enhancing patient engagement within HTA. Advocates deepened their understanding of HTA processes through direct participation and shared insights with wider patient networks, fostering a multiplier effect. Peer-to-peer knowledge dissemination expanded patient capacity, strengthening advocacy communities. Advocates utilized their experiences to host webinars, workshops, and community forums, broadening the reach of HTA knowledge. The initiative also improved the ability of patient networks to contribute meaningfully to decision-making processes. These outcomes highlight the model’s potential for creating sustainable, informed, and resilient advocacy communities equipped to address the challenges of rapidly evolving health technologies.

The Shared Learning model revolutionized patient engagement in HTA by emphasizing immersion, knowledge sharing, and network expansion. Through flexible programs like PVI Patient Partners, the model deepened engagement while enabling broader dissemination of insights. As health technologies rapidly evolve, this scalable approach ensures patient voices remain central to HTA decision-making, fostering informed, sustainable contributions within patient communities.

The Health Technology Assessment (HTA) Network of the Americas (RedETSA) is composed of health ministries, HTA agencies, regulatory authorities, and collaborating centers that exchange valuable cooperation and information to promote the HTA processes in the Americas region. Since its creation, the network has grown significantly, and several milestones have been reached.

A retrospective review of HTA milestones in the region and RedETSA network achievements was conducted, covering its inception at the HTAi annual meeting in Rio de Janeiro, Brazil, in 2011 to the present. The review included: the number of member countries and institutions; milestones in HTA development, implementation, and institutionalization; key Pan American Health Organization (PAHO) resolutions supporting HTA; advances in the Regional Database of Health Technology Assessment Reports of the Americas (BRISA); the number of annual meetings; regional and international cooperation; and capacity building support in the region.

Following the approval of the CSP28.R9 resolution on HTAs and Health Decision-Making by the PAHO in 2012 and the WHA67.23 resolution (World Health Organization) in 2014, HTA was implemented or institutionalized in several countries. Since its inception, RedETSA has grown to include 21 member countries in the Americas, represented by 40 institutions. HTA capacity building was supported by 482 scholarships and courses since 2015, as well as 43 webinars by RedETSA. The BRISA database now includes over 3,800 HTA reports. Moreover, RedETSA collaborates with various HTA institutions and initiatives, including HTAi, the International Network of Agencies for HTA (INAHTA), the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), RedCritieria (a network initiative of the Inter-American Development Bank), HTAsiaLink, and EuroScan.

Significant progress in HTA has been made in the Americas, with RedETSA playing a key role in these achievements. Challenges remain, including establishing explicit links between HTA and decision-making, consolidating institutional frameworks, increasing local data availability, continuing capacity building efforts, and standardizing HTA reports. Continued cooperation between countries and institutions through network collaboration is essential to address these needs.

Health technology assessment (HTA) evaluates the cost effectiveness and clinical efficacy of health technologies to inform policy decisions. Established in 2017 by the Department of Health Research, the Office of Health Technology Assessment in India is housed within the Ministry of Health and Family Welfare; however, challenges remain. This study analyzed gaps in India’s HTA framework to aid policymakers in making improvements.

The study conducted a systematic review of HTA literature and a focus group discussion with Ministry of Health representatives. A search on PubMed using “HTA” AND “India” yielded 74 papers from the last seven years, with 12 additional papers found through Google. Using the PRISMA methodology, titles, abstracts, and full texts were evaluated, and duplicates were managed with Zotero. Data were collected in an excel sheet, and the HTA scorecard from Türkiye helped identify context-specific gaps in India, which were discussed with six focus-group members from the HTA department at the Ministry of Health and Family Welfare and the National Health Systems Resource Centre.

The desk review identified gaps in India’s data usage, including a fragmented data ecosystem, limited electronic health records, and challenges with real-world evidence that affect HTA effectiveness. A major issue was the scarcity of trained professionals for high quality HTA and insufficient public funding for HTA research. The potential of HTA remains underutilized. Barriers to effective HTA legislation include the complexity of central policies, incoherence with state administration, and fragmented insurance schemes. Focus group participants recommended capacity building and orientation programs for the HTA department and state procurement, highlighting the need for funding to support implementation research for benchmark development.

India faces challenges in data infrastructure, stakeholder involvement, funding, and policy integration for HTA. Investments in data collection and training are essential. With initiatives such as Digital India and Make in India, the country aims to establish itself as a global digital economy. Strengthening HTA institutionalization and implementing an artificial intelligence-based HTA framework can position India as a leader in HTA.

To support decision-making regarding the introduction of digital health technologies (DHTs) with added value for patients and society, health technology assessment (HTA) frameworks for DHTs are needed. However, the absence of standardized definitions and taxonomies creates a barrier to the development of such a framework. This research addressed these challenges by developing a consensus-based unified definition and taxonomy for DHTs.

The study comprised a scoping review of existing definitions of DHTs, a targeted review of taxonomies used across European countries, and a two-round Delphi process. For the scoping review, data on the source identifier, type of DHT, the definition itself, and the purpose of the definition were extracted. For identified taxonomies, data on criteria of classification (e.g., functionality, risk, user), types of DHTs, and background of the classification (development process, purpose, and policy context) were extracted. Thematic analysis of both reviews informed the development of an online Delphi survey, distributed via several HTA stakeholder groups and societies, including HTAi.

We identified 8,651 unique records from four databases (PubMed, the Cochrane Library, Embase, EconLit) and extracted 328 definitions. Analysis revealed three key components of a definition for DHT: intended purpose, users, and underlying technology. The targeted review identified nine taxonomies classifying DHTs by maturity stages, intended purpose, digital health architecture, illness severity, personalization capacity, and levels of human intervention. The first round of the Delphi survey, with 118 complete responses, achieved consensus on the three key components, using intended purpose as a classification criterion. The results of the second round will be available in January 2025.

This study provided a unified definition for DHTs, incorporating three key components: intended purpose, users, and underlying technology. The Delphi process validated intended purpose as a primary classification criterion. This standardized definition and taxonomy streamlines assessment, enhances cross-border HTA collaboration, and enables stakeholders to compare and evaluate the impact of DHTs appropriately, thus fostering informed decision-making.

Patient involvement in health technology assessment (HTA) is increasingly valued globally but remains challenging, particularly in Brazil. Reporting tools like the Guidance for Reporting Involvement of Patients and the Public Short Form (GRIPP2-SF) help assess and enhance public participation efforts. This study evaluated the reporting of HTA documents published by the National Committee for Health Technology Incorporation (CONITEC).

We conducted a retrospective analysis of technical reports published by CONITEC between 1 January 2023 and 29 November 2024. We collected characterization data from reports that included the perspective of patients (PP) or public consultation (CP) item, in addition to the challenges for social participation. We used the GRIPP2-SF reporting guide, which has five items and aims to improve the quality of reporting on patient and public involvement in health and social care research. We performed a descriptive analysis of the data, presenting them as percentages and averages.

A total of 131 reports were evaluated, with 12,449 registered participants. Four documents did not include any social participation. Of the reports, 83 (63.3%) addressed the PP item and 48 (36.6%) addressed the PC item. The average duration of the public call was 13 days for PP and 18 days for PC. The experience report for the PP item was collected by consensus or random selection among patients. Challenges to social participation included lack of registration in the public call and failure to meet the inclusion criteria. Only the GRIPP2-SF “objectives, methods and results” items were described.

Application of GRIPP-2F in the critical evaluation of patient involvement highlighted the importance of continuing to investigate dynamic and simple approaches to patient integration into HTA reports. Including patients after the report is completed should not be the end point but a trigger for incorporating them throughout the process in future projects.

Drug out-referral occurs when patients must obtain prescribed medications from external pharmacies due to unavailability or unaffordability at healthcare facility pharmacies. This practice may burden patients financially, lead to health complications, and disrupt the revenue and workflow of healthcare facilities. The study evaluated the economic costs incurred by patients and the potential revenue loss for the University of Ghana Medical Centre (UGMC) due to out-referrals for antihypertensive medications.

This cross-sectional study took place from September to October 2023. Data on prescribed and dispensed drugs and their prices were collected from the UGMC electronic database and compared with prices from selected local pharmacies. Cost analyses were conducted from both patient and healthcare provider perspectives. Exit interviews with 367 outpatients who experienced drug out-referrals captured financial and productivity cost burden data. Microsoft Excel was used for data analysis, presenting results as frequencies and percentages.

The rate of drug out-referral at UGMC was significant, with 48 percent (5,378/11,220) of prescribed drugs not dispensed at the UGMC pharmacy, a reduction from 54 percent from 2022. Over two months, UGMC’s revenue loss on undispensed antihypertensive drugs alone was GHS43,009.61 (USD3,669.76). Patients referred for antihypertensive drugs incurred a mean direct cost of GHS18.32 (USD1.56) and an indirect cost of GHS26.15 (USD2.23), totaling GHS44.47 (USD3.79) in economic costs, alongside intangible costs such as disappointment (54%), frustration (51%), and stress (54%).

Addressing drug out-referral is essential for enhancing patient care and healthcare facility efficiency. That is, evaluating and highlighting the economic impact of this practice can drive economic growth and innovation to identify cost-effective solutions and improve resource allocation. These insights can strengthen global health systems by ensuring that healthcare practices are both economically viable and beneficial to patient outcomes.

The aim of this study was to explore the acceptability of an educational video among primary care clinicians as a tool to promote the use of stigma-free language in interactions with individuals with type 2 diabetes (T2D).

The language used by primary care clinicians in interactions with adults living with T2D can contribute to perceptions and experiences of diabetes-related stigma and be a barrier to achieving and sustaining glycaemic targets. In 2017, the American Diabetes Association (ADA) and the Association for Diabetes Care & Education Specialists (ADCES) issued a guidance paper with recommendations to promote stigma-free communication about diabetes.

The educational video, developed by the research team, presents two versions of a vignette in which a nurse practitioner interacts with an adult with T2D in a primary care setting. The first version of the vignette features the nurse practitioner using stigmatizing language as outlined in the ADA and ADCES guidance paper; the second demonstrates the use of stigma-free language by the nurse practitioner. A narrator highlights the linguistic differences. The study participants, comprising physicians (n = 8), nurse practitioners (n = 9), and physician assistants (n = 1), were recruited through professional networks and via online forums and listservs for healthcare professionals. Participants viewed the educational video and were interviewed via Zoom by a research team member using a semi-structured interview guide. The transcripts of the interviews were analysed using a qualitative descriptive approach.

Three main themes emerged from the data: aligning video content with existing attitudes and beliefs, reducing the use of stigmatizing language, and increasing the use of stigma-free language. Findings suggest that an educational video promoting the use of stigma-free language in interactions with adults with T2D is acceptable among primary care clinicians.

Immunoglobulin G (IgG) is a high-cost drug, leading our hospital pharmacy expense ranking since 2015, with a rising utilization trend from 16 percent of expenses in 2018 to 27 percent in 2023. The health technology assessment (HTA) unit at Hospital Garrahan proactively undertook sequential interventions to control variability, overutilization, costs, and resource use in the administration of IgG to pediatric patients with immune deficiencies. We report the results of a guideline implementation and a cost-minimization analysis.

An evidence-based guideline on adequate IgG use was developed, indicating similar effectiveness for subcutaneous (SCIG) and intravenous IgG (IVIG) in replacement therapy for pediatric immune deficiencies. As the switch to SCIG was rejected due to higher cost, a sequential cost-minimization analysis was performed as SCIG hospital purchase prices decreased over time. Real-world data were collected from the hospital system on IgG units consumed, acquisition prices, and percentage of drug expenses from 2018 to 2023. Daycare bed occupation was calculated assuming monthly four-hour infusions for supplementary IVIG for all registered patients. Costs are expressed in Argentine pesos and equivalent American dollars.

In 2022, switching from IVIG to SCIG had an estimated annual budget impact of ARS51,189,073 (USD392,795); the proposal was rejected on cost grounds. The switch was recommended again in 2023 when prices of alternatives became equivalent. By 2024, the initial price situation reversed, and the change implied annual estimated savings of ARS4,413,487,361 (USD4.931.270). Sensitivity analysis considering price variations determined minimum annual savings of ARS1,408,175,937 (USD1,573,380). The switch was also estimated to free 432 daycare beds per year (1.8 beds/day) and 2,400 annual nurse work hours. The recommendation was finally accepted by managers and communicated to clinicians and specialists.

Switching from IVIG to SCIG in pediatric immune deficiency patients can reduce hospital expenses, bed occupation, and nursing hours; additionally, it can prevent monthly hospital visits and subsequent school absenteeism. Hospital-based HTA can have a positive impact on cost reductions without sacrificing healthcare quality, especially by controlling adequate utilization of high-cost drugs and disinvesting in outdated technologies.

Telemedicine capacity has evolved and currently offers excellent tools for fortifying health screening systems, particularly for building a cost-effective screening network for the early diagnosis of breast cancer. In this context, a telemedicine driven approach should be directed toward improving breast cancer screening innovation in underserved hospitals. This study evaluated the results of a telemedicine-driven breast cancer diagnostic network in remote public hospitals in Paraguay.

This is a descriptive study, where the results using telemedicine-driven breast cancer diagnosis innovations in remote public hospitals were evaluated for their ability to improve accessibility and equity to specialized diagnostic services countrywide. For this purpose, the type and frequency of diagnoses performed through a telemedicine platform was determined.

During the study, a digital telemedicine-driven breast cancer screening network was implemented in 34 hospitals countrywide. The screening procedure involved analyzing a digitally acquired mammogram for masses, calcifications, or areas of abnormal density that may indicate the presence of cancer. The implemented cancer screening network performed 840 tests between October and November 2024. This resulted in the following diagnoses: normal (60%); cyst (33%); and fibroadenoma, macrocalcifications, and abnormal area (7%). If there is a significant suspicion of cancer, then tissue will be removed for a biopsy and examined by a pathologist.

According to our results, the telemedicine-driven breast cancer screening innovation network facilitated a timely, pertinent, high-quality tertiary level diagnostic service with equitable access for patients in remote underserved public hospitals in Paraguay. A widespread use assessment is necessary before this breast cancer screening method can be implemented.

Evidence synthesis is the foundation of health technology assessment (HTA); however, systematic literature reviews (SLRs) are highly resource intensive. While augmentation with artificial intelligence (AI) theoretically offers to make this rigorous process more efficient, it is unclear whether AI-supported SLRs will be widely accepted among HTA bodies. This study’s objective was to evaluate how HTA bodies regard the use of AI-supported SLRs.

A targeted literature review (TLR) (January 2019 to October 2024) was conducted in Embase, MEDLINE, and the gray literature. Search terms included AI, natural language processing, large language models, and machine learning. The TLR informed development of a survey to be fielded to respondents from HTA bodies and questions for qualitative interviews.

The TLR found that most HTA bodies do not address using AI for SLRs. Two that do are the National Institute for Health and Care Excellence (England) and the Institute for Quality and Efficiency in Health Care (Germany). Both suggested that AI can support human efforts across multiple SLR phases. Respondents from Europe and the USA completed the survey and qualitative interviews. Most respondents had some familiarity with using AI in SLRs but said their respective organizations doubted AI’s utility in improving the quality of SLRs. Respondents stated the primary responsibility for AI tool development and validation should not rest with manufacturers.

Most HTA bodies do not address using AI for SLRs, but respondents said that AI might improve SLR production by augmenting (not replacing) human effort. Gaining acceptance for AI use in SLRs for HTA will require multistakeholder engagement to ensure transparency and reliability. HTA bodies will need appropriate infrastructure and legal frameworks so that they can test and use AI software.

Respiratory syncytial virus (RSV) is a leading cause of severe respiratory illness in infants worldwide and is associated with significant morbidity. This study evaluated inequities in RSV-related hospitalizations among Brazilian infants under one year of age. Our objective was to evaluate how socioeconomic disparities impact RSV burden and cost-effectiveness metrics for RSV vaccination strategies.

A hybrid model combining a Markov framework and a decision tree was developed. The coefficient of hospitalization was estimated using the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos) and the Hospital Information System (Sistema de Informações Hospitalares). RSV-related hospitalizations were identified using International Classification of Diseases, 10th Revision codes, and deprivation quintiles were defined by the BrazDep index. The RSV hospitalization risk reduction of 0.30 was extrapolated from the literature for the first year of life. Incremental cost-effectiveness ratios (ICERs) were calculated using Brazil’s cost-effectiveness threshold of USD6,873 (USD1=BRL5.82).

Infants in the most deprived quintile experienced 33-fold higher hospitalization rates compared with the least deprived quintile. At the current vaccine price of USD47.82, the ICER was USD26,934, exceeding the national threshold. Cost effectiveness was only achieved in the most deprived quintile, where the vaccine price threshold was USD48.29. Threshold prices for quintiles two to five were significantly lower: USD12.21, USD6.01, USD4.42, and USD2.15, respectively. Vaccination reduced hospitalization risk proportionally across quintiles, but the burden remained disproportionately high in the most deprived quintile.

At the current price, RSV vaccination was not cost effective in most scenarios in Brazil, with ICERs exceeding the national threshold. Cost effectiveness was achieved only in the most deprived quintile, where the disease burden is highest. To align with Brazil’s threshold, significant price reductions or targeted subsidies would be necessary to ensure equitable vaccine access and public health impact.

Health technology assessment (HTA) bodies published stringent criteria for cost-minimization analyses (CMA), but evidence shows that many appraisals still fail to meet their full requirements: notably, adequately powered trials showing non-inferior outcomes regarding minimal clinically important difference. Here, we report the use of CMA in recommending biological disease-modifying antirheumatic drugs (bDMARDs) in psoriatic arthritis.

A comprehensive review of HTA agency reports was conducted to identify the economic evaluations applied in the appraisal of bDMARDs for psoriatic arthritis. Data were collected from publicly available HTA databases and official websites of globally recognized agencies. The search included appraisals published up to December 2024. Evaluations were categorized based on the economic model used (e.g., CMA, cost effectiveness, cost utility, or cost benefit). Extracted data were analyzed to summarize trends and identify differences in the economic approaches used among agencies.

Cost-effectiveness and cost-utility analyses were the predominant approaches in HTA agency assessments of bDMARDs for psoriatic arthritis. Certolizumab pegol, golimumab, and secukinumab were the most frequently evaluated medications, each with nine evaluations. The Brazilian National National Committee for Health Technology Incorporation (CONITEC) was the only agency that exclusively used CMA in all its evaluations. In contrast, the National Institute for Health and Care Excellence (NICE) did not use this methodology in its assessments.

Our findings highlight the significant variation in economic evaluation methods used by HTA agencies for bDMARDs in psoriatic arthritis. The inappropriateness of superiority trials that fail to reject the null hypothesis for CMA is a key takeaway. While CMA remain relevant due to their simplicity, their use by CONITEC contrasts with broader methodologies preferred by other agencies, particularly NICE.

Horizon scanning (HS) systematically identifies emerging health technologies to support future decision-making. However, HS methods face challenges due to inconsistent terminology and lack of reporting standards. This hinders dissemination and increases research waste. Unlike PRISMA for evidence synthesis, no reporting guidelines exist to support HS. This work proposed a preliminary reporting checklist.

In July 2024, a working group comprising HS analysts, evidence synthesis researchers, and information specialists was established at the Innovation Observatory (IO), the UK’s national HS organization. The group convened three times to define objectives, refine methods, and develop the reporting checklist. In the first meeting, we outlined a prototype by adapting the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We internally validated it on 25 IO HS reports (2017 to 2024). The second meeting assessed the relevance of each checklist item following our internal validation. In the third meeting, additional items were proposed based on the validation’s results, and the group reached consensus on the final checklist.

The final checklist prototype comprised a total of 35 items of which 29 were essential and six optional. It introduced new key elements absent in PRISMA-ScR: “interest holder description” in the introduction, “horizon-scanning scope” in the methods, “technology characteristics” in the results and “political, economic, societal, technological, legal and environmental (PESTLE) interpretation” in the discussion. Additionally, the checklist was tailored to promote transparency, equity, fairness, and sustainability in signal detection processes over those characteristics in evidence synthesis, aligning with the goals of HS. The checklist is available to download in the Open Science Framework.

Our checklist addressed a critical methodological gap, advancing HS research by promoting standardization and transparency of HS methods. By making the draft checklist available, we encourage HS practitioners to pilot it. Feedback is welcomed to contribute to the final checklist. Its adoption and endorsement will improve output visibility, ensuring this meets necessary methodological standards underpinning unbiased healthcare policy decision-making.