OBJECTIVES: Successful health technology assessment (HTA) is fundamental in achieving patient access for new medicines in global markets. HTA outcomes can offer differ by country and are intrinsically related to product characteristics. The objectives of this study were to identify therapy related factors that influence reimbursement success across seven countries with universal health-care systems, and to examine any between-country differences.

METHODS: HTA appraisals conducted between January 2023 and December 2023 in seven countries with universal healthcare systems (England, Scotland, France, Denmark, Spain, Australia, and Canada) were reviewed. Data were collected on date of appraisal, HTA type, and reimbursement decision, as well as a range of product-related factors including indication, therapeutic area, target age-group, and advanced therapy medicinal product or orphan status. Univariate logistic regression models were used to examine the relationship between each of these factors and reimbursement decision. Multivariate analyses were conducted to determine whether relationships changed according to country.

RESULTS: In 2023, a total of 592 HTA appraisals were conducted across the seven countries, of which 460 (78%) resulted in a positive reimbursement recommendation. Univariate analyses demonstrated that two of the therapeutic factors assessed were significantly associated with reimbursement decision: indicated age-group, with the odds of reimbursement success being 3.8 times higher in paediatric indications (95% CI: 1.44, 12.95); and therapeutic area, with oncology products being less likely to be reimbursed than other disease areas (odds ratio: 0.64 [0.44, 0.95]). These relationships varied according to country.

CONCLUSIONS: The results of this study suggest that HTA appraisals for products with paediatric or non-oncological indications are associated with a higher likelihood of successful reimbursement. Relationships between therapy-related factors and reimbursement success differed according to country, providing potential insight into optimal launch markets.