OBJECTIVES: In light of the Joint Position Statement published in April 2023, we sought to carry out a targeted review (TR) of health technology assessments (HTA). We reviewed HTA reports from the National Institute for Health and Care Excellence (NICE) in the UK, the Canadian Agency for Drugs and Technologies in Health (CADTH) in Canada, and the Institute for Clinical and Economic Review (ICER) in the US) to examine whether the objective for increased collaboration and transparency is reflected in their reimbursement decisions.

METHODS: We performed a TR of NICE assessments published in 2023 and matched to find assessments for identical therapies and indications from 2021 to 2023 from CADTH and ICER. This date range was selected to account for launch sequencing in the UK versus the US and Canada. The outcome of the selected assessments was recorded, as well as key rationale for the decision.

RESULTS: A total of 93 assessments were performed by NICE in 2023, compared with 7 by ICER and 64 by CADTH. Each HTA body had an 87%, 71% and 86% positive recommendation rate, respectively. Only three therapies were assessed by all three bodies in the selected date range (semaglutide in weight management, mavacamten in cardiomyopathy and paxlovid in COVID-19). Only mavacamten and paxlovid had identical outcomes in all three countries (recommended), whereas semaglutide had a divergent outcome (not recommended) in Canada, compared with ICER and NICE (recommended). Reasons cited for its negative recommendation were both clinical and economic (insufficient clinical claim and large discount required to meet cost-effectiveness threshold).

CONCLUSIONS: Despite the objective to increase collaboration between countries, the selection criteria differ between NICE, ICER and CADTH, resulting in varying reimbursement decisions. Further assessment and monitoring of this collaboration is required to fully evaluate the success of the Joint Position Statement.