Advancing patient involvement in health technology assessment; a proposal and initial validation of concrete strategies for educational, methodological and institutional improvements

Abstract

Background: meaningful patient involvement in Health Technology Assessment (HTA) is increasingly recognized as essential to ensure transparency and relevance in health policy decisions. Despite this, methodological implementation remains inconsistent across different countries, often limited by a lack of educated patients, practical guidance and structural support.

Objective: This study aimed to gather evidence to support the development of concrete strategies for advancing meaningful and efficient patient involvement in the HTA process, with a focus on patient education, methodological guidance and institutional integration.

Methods: A targeted literature review was conducted to identify key recommendations for improving patient involvement in HTA. The key topics were translated into 16 survey statements across four domains. The survey was distributed to stakeholders from the general population, pharmaceutical industry, HTA experts, and other healthcare professionals across several countries. Responses were analysed with the Kruskal–Wallis or Mann–Whitney U test to explore group and country-level differences.

Results: A total of 40 stakeholders responded. Respondents emphasised the importance of continuous and accessible patient education, early engagement in the HTA process and clearly defined roles to enhance the quality and effectiveness of patient participation. More rigid or formalised requirements appear to be met with mixed opinions.

Conclusions: Stakeholders broadly support more structured and demanding approaches to patient involvement in HTA, particularly in terms of education and methodological clarity. The recommendations presented in this report can serve as a valuable starting point for enhancing meaningful and sustainable patient involvement in HTA. Future research should focus on developing accessible training programmes and implementing formal guidelines to ensure systematic and meaningful patient participation.