HEMA initiative publishes inaugural report on measuring treatment benefits in HTA

The Health Economics Methods Advisory initiative (HEMA) has published its first report examining how treatment benefits are defined and measured in economic evaluations used to inform health technology assessment (HTA) decision-making.

Established by three HTA organizations, the National Institute for Health and Care Excellence (NICE), the Institute for Clinical and Economic Review (ICER), and Canada’s Drug Agency (CDA-AMC), the HEMA initiative aims to support independent research on methodological questions facing HTA systems internationally.

The inaugural report, Defining Appropriate Benefits for Economic Evaluation of Health Care Technologies, examines how HTA organizations might evaluate potential changes to the types of benefits considered in economic assessments. It aims to provide a framework to help HTA organizations decide whether and how the benefits used in economic evaluation should evolve.

Specifically, the report sets out three objectives:

• To propose guiding principles for evaluating potential changes to the benefit function used in economic evaluation
• To review recent proposals to expand or adapt how benefits are measured in HTA
• To apply these principles to those proposals with recommendations for decision-makers

The framework is built around three guiding principles used to assess whether additional elements of benefit should be incorporated into economic evaluation: relevance, valuation, and opportunity cost. Relevance considers whether a proposed benefit aligns with the remit and responsibilities of HTA organizations. Valuation addresses how different benefits are aggregated and weighted within economic evaluation, while opportunity cost focuses on the trade-offs involved when allocating limited healthcare resources to one intervention rather than another.

The report also examines several additional measures of benefit that have been discussed in the HTA literature. These include impacts beyond the patient, such as effects on caregivers and family members, as well as productivity impacts, individuals’ attitudes toward health-related risk, and the potential equity implications of new interventions.

The final publication follows the release of a draft version in October 2025 and a subsequent period of global stakeholder consultation. Feedback was received from a wide range of organizations, including pharmaceutical companies, academic institutions, health policy groups, and patient organizations. While broadly welcoming the report’s objectives, the feedback focused on several methodological and practical considerations. Several responses highlighted the importance of ensuring patient and caregiver perspectives are adequately reflected in benefit measurement, alongside concerns about evidentiary standards, valuation approaches, and how expanding the benefit framework could affect future HTA decision-making.

HEMA will host a public webinar on March 23, 2026, moderated by Nicole Mittmann (CDA-AMC), to discuss the report. Panelists will include R. Brett McQueen (University of Colorado Anschutz Medical Campus), Samantha Benham-Hermetz (Alzheimer’s Research UK), Anirban Basu (University of Washington School of Pharmacy) and Dawn Lee (University of Exeter).