ABSTRACT
This chapter considers the potential factors predictive of successful Health Technology assessments (HTAs) using available data and discusses some practical issues in HTAs when designing cancer trials for cost-effectiveness. It also discusses reimbursement strategies and experiences across several countries within Europe. In the United Kingdom (UK), National Institute for Health and Care Excellence appears to have one of the most comprehensive and transparent approaches to evaluating cost-effectiveness. The uncertainties around the exit of the UK from the European Union have created uncertainties for both reimbursement and market authorization bodies. Understanding payers and payer systems is a key element to understanding global market access, drug pricing, and reimbursement. The chapter describes briefly some approaches for HTA in other countries, including the US. There have been large increases in the costs of cancer care worldwide and there is real concern that cancer treatment is becoming unsustainable.
