Health technology assessment

The HTA center of Swedish Västra Götaland region has published a report for the impact of postmastectomy radiotherapy (PMRT) on complications and results of immediate breast reconstruction (IBR). PMRT compared with no radiotherapy (RT) results in a clinically significant increase of implant or tissue expander loss in patients undergoing IBR with moderate certainty of evidence. Other findings (decrease in patient satisfaction, an increase of re-operations or capsular contracture rate increase) gained low certainty of evidence.

In June 2019, the National Institute for Health and Care Excellence (NICE) published six new interventional procedure guidance, one new Medical technologies guidance for Endocuff Vision for assisting visualisation during colonoscopy, and two new MedTech innovation briefings (for Danis stent for acute oesophageal variceal bleeds, and The OPTIMIZER smart system for managing heart failure).

The mini-HTA for internal emergency medicine ultrasound in patients with urgent medical conditions was released in July 2019 in Norway. The method was determined as efficient, safe, and was recommended to be introduced as part of the clinical routine in the hospital.

In late June 2019, the Committee on Evaluation and Public Health (CEESP) of the French High Authority for Health (HAS) validated a second, provisional version, updating the methodological guide for the evaluation of effectiveness at the HAS.

In June 2019, the Norwegian Institute of Public Health (NIPH) has released an HTA report for prehospital CT for early diagnosis and treatment of suspected acute stroke or severe head injury to evaluate the documentation for clinical efficacy, safety and possible initiation of treatment prior to arrival in hospitals, compared with current hospital practice. Although the mobile stroke unit care increases the number of patients who receive thrombolysis, its efficacy is unknown due to the lack of evidence.

In June 2019, the Dental and Pharmaceutical Benefits Agency (TLV) has published a completed health economic evaluation regarding the cost-effectiveness of the comprehensive genomic profiling test for all solid tumors FoundationOne CDx. TLV believes that in most cases, the use of FoundationOne CDx is more expensive in comparison to current treatment methods. However, it has greater sensitivity and accuracy in the diagnostics.

In June 2019, the Norwegian Institute of Public Health (NIPH) has released an HTA report for TAVI in patients with severe aortic stenosis and intermediate surgical risk commissioned by the National System for Managed Introduction of New Health Technologies within the Specialist Health Service in Norway. The cost-utility analysis indicated that TAVI was slightly more effective and more costly than open surgery. These findings can help decision makers appraise the intervention against the official priority setting criteria in health care sector applicable in Norway.

In June 2019, the Belgian Health Care Knowledge Center (KCE) published a report of the health technology assessment of bariatric surgery.

Mini-method assessment regarding the treatment of lymphedema with lymph node transplantation after breast cancer treatment was initiated by Oslo University Hospital in June 2019. The finalized mini-method evaluation will be published in the National Database for Mini-HTA.

In May 2019, the National Institute for Health and Care Excellence (NICE) published one new diagnostics guidance for Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care, three new interventional procedure guidance (for therapeutic hypothermia for acute ischaemic stroke, collagen paste for closing an anal fistula, and percutaneous mitral valve leaflet repair for mitral regurgitation), two new Medical technologies guidance, and three new MedTech innovation briefings (for SEM Scanner for pressure ulcer prevention, Peezy Midstream for urine collection,and DuraGraft for preserving vascular grafts).

The German Institute for Quality and Efficiency in Health Care (IQWiG) has investigated whether patients suffering from non-Hodgkin lymphoma have (better) chances of recovery in case of allogeneic stem cell transplantation. IQWiG concluded that the benefit of allogeneic SCT is unclear.

In mid-May 2019, the network of European HTA agencies, EUnetHTA, announced the final plan of the project OTCA18 “Regional hyperthermia for high-risk soft tissue sarcoma treatment.”