Key Issues of Economic Evaluations for Health Technology Assessment in China: A Nationwide Expert Survey.

Health technology assessment (HTA) is increasingly crucial in medicine price negotiations in China, yet previous appraisals revealed national discrepancies on key economic evaluation issues: willingness-to-pay threshold, pricing models for multi-indication medicines, and comparator selection principles. This study aimed to collect expert opinions on these issues for future HTA evaluations. A nationwide anonymous web-based survey encompassing experts across academia, HTA, consultancy/contract research organization/industry, service provider, and payer. In 2023, a generic invitation containing a web link to the questionnaire was disseminated via WeChat using convenience and snowball sampling. Agreement rates for questionnaire views were analyzed using descriptive statistics. The relationship between participants' responses and demographics was examined using appropriate logistic models. A total of 303 responses were received from experts in 34 cities. Key expert views include a suggested base willingness-to-pay threshold ranging from 0.5 to 1.5 times gross domestic product (52.1% agreement); elevated thresholds for childhood diseases, rare diseases, end-of-life diseases, and first-in-class medicines (>78.0% agreement); a single pricing model for multi-indication medicines (60.4% agreement); consideration of multiple medicines as comparators (79.9% agreement); and avoiding the use of centrally procured medicines as comparators for medicines with a time to market of less than 3 years (71.0% agreement). Participants who are service provider had lower odds of selecting higher thresholds (odds ratio 0.26; P <.01) than responders from consultancy/contract research organization/industry. Expert views indicate the need for substantial changes in China's current HTA methods, highlighting the need for increased investment in HTA processes and expertise cultivation. • Since 2017, health technology assessment (HTA) has played a key role in price negotiations for medicines seeking coverage under China's national Social Health Insurance program. However, past HTA appraisals have revealed a lack of national consensus on various issues relating to economic evaluation, with particular focus on 3 key areas: willingness-to-pay thresholds, pricing models for multi-indication medicines, and comparator selection principles. • To address these gaps, we conducted a pioneering nationwide survey to gather perspectives from diverse stakeholders on the 3 key issues. Our study, one of the earliest global initiatives to systematically collect views on economic evaluations for HTA, received 303 responses from experts across 34 cities. This diverse sample, including participants from academia, HTA, consultancy, industry, service providers, and payers, ensures comprehensive insights. • Key expert views derived from this survey included a suggested base willingness-to-pay threshold ranging from 0.5 to 1.5 times gross domestic product; elevated thresholds for childhood diseases, rare diseases, end-of-life diseases, and first-in-class medicines; a single pricing model for multi-indication medicines; and consideration of multiple medicines as comparators. Implementing these recommendations would require substantial changes to China's HTA methods, highlighting the need for increased investment in HTA processes and expertise cultivation. [ABSTRACT FROM AUTHOR]