EU HTA PICO Framework for Medical Devices

MTRC provides Early PICO Planning services to support a smooth and effective Joint Clinical Assessment (JCA) process under the new EU Health Technology Assessment (HTA) Regulation for innovative medical devices.

With the enforcement of the EU HTA Regulation, medical device manufacturers face intensified requirements to demonstrate clinical value for market access, HTA endorsement, and reimbursement across the European Union. The Joint Clinical Assessment (JCA) will be a pivotal step in this process.

A key component of the JCA is scoping, which uses the PICO (Population, Intervention, Comparator, Outcomes) framework to define the specific parameters of an HTA review:

Population: The patient demographic or clinical setting for which the device is intended
Intervention: The medical device or procedure being evaluated
Comparator: The current standard of care or alternative solutions
Outcomes: Clinical, patient-centric, or economic measures assessing effectiveness and safety

One challenge of the JCA PICO process is that each EU member state can submit inputs, potentially leading to numerous final PICOs. This complexity means manufacturers must address all suggested populations, comparators, and outcomes in a very short time, reserved for development of the HTA application. Member-state-driven variability and tight timelines can be a major hurdle for successful preparation.

MTRC’s unique expertise in EU Med Tech market access, HTA, and PICO-driven planning helps you navigate these challenges with confidence, ensuring a stronger market position for your medical technologies.

Early PICO Planning Process

At MTRC, we guide you through each stage of HTA preparation with a focus on creating an optimized PICO framework for your medical device.

Analyze the Current Diagnostic and Treatment Landscape in All Member States

We analyze clinical guidelines by clinical societies and governmental organizations (e.g. HAS in France and National Board of Health and Welfare in Sweden), audits and patient registries as well as published surveys of physicians or medical chart reviews to understand current patient pathways in all member states.

Determine the Position of Reimbursement and HTA Authorities

We evaluate perspectives from reimbursement and HTA organizations by examining previously published HTA reports, reimbursement decisions, and other relevant documents. This helps us identify member-state-specific patient populations, preferred comparators (reflecting the standard of care), and outcomes, all of which may vary significantly by country.

Consolidate PICOs for All Member States

Utilizing analysis of current clinical practice, previous reimbursement and HTA decisions, we develop a comprehensive list of potential PICOs. This consolidated framework reflects variations in practice and payer expectations across EU member states.

Develop Strategic Recommendations for Evidence Generation

We conclude the process by providing a strategic gap analysis and recommending next steps for evidence generation, ensuring you are well-prepared for a successful JCA submission.

Why partner with MTRC?

Be confident in the results

We are accredited by the United Kingdom Accreditation Service (UKAS) as an ISO 9001:2015 certified vendor, specialised in medical technologies market access. Unlike many of our competitors, we dedicate 100% of our time and focus to the area of medical technologies, so that our clients enjoy higher quality services at a lower cost. We are also probably the largest Med Tech market access consultancy in Europe, which helps us accumulate unique knowledge and insights. MTRC is a proud member of ABHI, the UK’s leading industry association for health technology (HealthTech)

Leverage unique Pan-European expertise

MTRC covers 20 European countries, including Austria, Belgium, Czech Republic, Denmark, England, Finland, France, Germany, Hungary, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Romania, Spain, Sweden, and Switzerland. Our unparalleled breadth uniquely positions us to address the diverse requirements of multiple EU member states in the JCA preparation process.

Spend less on consulting

We understand the budgetary challenges of the med tech industry and can therefore offer a cost-effective approach to our specialised services. Twelve (12%) of our current business comes from small to medium-sized enterprises (SMEs) – a testament to our unique and personal approach to solve your budgetary challenges

Make decisions and advance your business quickly

We appreciate the time-sensitive nature of market access. Being a flexible team, we are not afraid to go beyond regular working hours to meet the high expectations of our clients. For every type of project, we offer the shortest possible turnaround times

News and insights

23 Jun 2025

EU HTA Publication Digest: The Art of Bridge Building: A Look at the European-Level Cooperation in HTA (EU-HTA)

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. In a recent publication, Ivo et al. examined the evolution and future prospects of European-level cooperation in health technology assessment, focusing on the implementation of the EU HTA Regulation. The authors highlighted the critical role of harmonised methodologies and coordinated capacity building in overcoming national heterogeneity. The new regulation is expected to streamline assessments, improve efficiency, and accelerate equitable access to innovative health technologies across Europe.

18 Jun 2025

EU HTA Publication Digest: Enhancing Patient Engagement in HTA: Using Consensus Research to Overcome PICO Scoping Challenges Under the EU HTAR

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. In a recent publication, Arcà et al. addressed the persistent challenge of integrating patient perspectives into PICO scoping for Health Technology Assessment (HTA) under the EU HTA Regulation. The authors proposed a structured framework based on the Delphi panel methodology to enhance the validity and transparency of patient contributions, facilitating structured engagement and consensus among patients and caregivers across Europe. This approach is designed to better align stakeholder expectations with HTA outcomes, and a study is currently underway to assess its practical feasibility.

10 Jun 2025

EU HTA Publication Digest: Regulatory landscape of accelerated approval pathways for medical devices in the United States and the European Union

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. In a recent publication, Gupte et al. conducted a review of accelerated approval pathways for medical devices in the United States and the European Union. The authors found that while the US Breakthrough Devices Program granted marketing authorization to just 12.3% of 1,041 designated devices between 2015 and 2024, approval was achieved substantially faster than through standard routes. In the EU, where no specific accelerated pathway exists, newly introduced Medical Device and Health Technology Assessment Regulations aim to harmonize approvals, with joint clinical assessments set to begin in 2026. The authors highlight that aligning regulatory, funding, and coverage policies is essential for device accessibility, and call for global convergence of standards and post-market surveillance to balance innovation with patient safety.

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