BOSTON, LONDON, OTTAWA, March 11, 2026 – The Health Economics Methods Advisory (HEMA) today released a report providing a framework to help health technology assessment (HTA) organizations decide which benefits should be included in economic evaluations. The final report outlines three guiding principles for evaluating the appropriateness of changes to measuring benefits, and the report further explores additional measures of benefit,including impacts on productivity, individual patients’ attitudes to risk around their health, and the equity implications of new interventions, among others.
Downloads: Final Report | Plain Language Summary | Public Comments | Response to Comments | Letter of Dissent
“Throughout the report development process, we used three guiding principles to support our recommendations on additional benefits that may be included in HTA,” said Mark Sculpher, PhD, Chair of the HEMA Working Group. “This process made it clear that if HTA groups expand the scope of benefits included, this broader view of benefits must still acknowledge the underlying challenge of how to use health care system funding to pay for therapies that deliver value to patients and the health system in a sustainable way.”
The key report takeaways include:
- A set of recommendations for HTA agencies to consider, which reflect three key principles to apply to evaluating the appropriateness of including additional benefits:
- Relevance: Does this factor align with what HTA organizations are responsible for considering?Measurability: Can this factor be measured appropriately and consistently across different treatments and conditions?
- Opportunity Costs: If we invest in one therapy, what are the tradeoffs in other parts of the health system? What are other potential investments we may not make?
- It is appropriate for HTA organizations to consider the health impacts of disease and treatment, regardless of who is impacted (e.g., patient, caregiver, family members, etc.), while continuing to explore any practical implementation challenges.
- Incorporation of individuals’ risk preferences into HTA can be considered, but such consideration needs to address whose preferences should be measured, which aspects of health these preferences should be applied to, and whether including risk preferences would significantly impact HTA decisions.
- If broadening the perspective of economic evaluation to include benefits to the wider economy is considered consistent with decision makers’ remits, additional evidence requirements must be considered to incorporate opportunity costs and other relevant trade-offs.
Public Webinar
HEMA will host a public webinar at 11:00 AM ET on March 23, 2026, to discuss the report findings. Register here.
The webinar will be moderated by Dr. Nicole Mittmann, PhD, MSc, Chief Scientist and Vice President of Evidence at CDA-AMC and a member of the HEMA Secretariat. Webinar panelists will include:
- R. Brett McQueen, PhD, Associate Professor, University of Colorado Anschutz – Department of Clinical Pharmacy (member of the HEMA Working Group and author on the report), USA
- Samantha Benham-Hermetz, BSc, Executive Director of Policy and Communications, Alzheimer’s Research UK (member of the HEMA Steering Committee), UK
- Anirban Basu, PhD, MS, Director & Professor of Health Economics, University of Washington School of Pharmacy, USA
- Dawn Lee, MSc, MMath, Associate Professor, PenTAG, University of Exeter, UK
HEMA was convened by the leaders of three global HTA organizations to critically and independently examine and assess new methods and processes. The three institutions are the USA-based Institute for Clinical and Economic Review (ICER), England’s National Institute for Health and Care Excellence (NICE), and Canada’s Drug Agency (CDA-AMC).
The intent of HEMA’s work is to provide actionable guidance to these and other HTA bodies. Importantly, because HEMA operates independently, HTA organizations are free to decide whether to implement the guidance, and HEMA is similarly free to decide whether to revise its guidance based on comments received.
Visit HEMA’s website for more information on the HEMA Working Group Guiding Principles.
About ICER
The Institute for Clinical and Economic Review (ICER) is an independent, non-profit research institute that conducts evidence-based reviews of health care interventions, including prescription drugs, other treatments, and diagnostic tests. In collaboration with patients, clinical experts, and other key stakeholders, ICER analyzes the available evidence on the benefits and risks of these interventions to measure their value and suggest fair prices. ICER also regularly reports on the barriers to care for patients and recommends solutions to ensure fair access to prescription drugs. For more information about ICER, please visit www.icer.org.
About NICE
NICE helps practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer.
We do this by:
- Producing useful and usable guidance for health and care practitioners.
- Providing rigorous, independent assessment of complex evidence for new health technologies.
- Developing recommendations that focus on what matters most and drive innovation into the hands of health and care practitioners.
- Encouraging the uptake of best practice to improve outcomes for everyone.
About Canada’s Drug Agency
Canada’s Drug Agency (CDA-AMC)is a pan-Canadian health organization. Created and funded by Canada’s federal, provincial, and territorial governments, we’re responsible for driving better coordination, alignment, and public value within Canada’s drug and health technology landscape. We provide Canada’s health system leaders with independent evidence and advice so they can make informed drug, health technology, and health system decisions, and we collaborate with national and international partners to enhance our collective impact.
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