Research

Health Technology Assessments (HTAs) have a long history and an increasingly high policy relevance.

Michael Schlander’s interest in the field originated in the early 1990s when he realized that the value of new medicines needed to be supported by clinical evidence not only on efficacy, but also on comparative effectiveness and cost effectiveness – even before the inception of the National Institute for Clinical Excellence (NICE) in 1999. As early as in 1998, while still working for the research-based biopharmaceutical industry, he published a monograph on «The Contribution of Health Economics to Market-Oriented Pharmaceutical Research and Development» with Witten-Herdecke University Press.

Following his transition from industry back to academia in 2002, and after his foundation of the not-for-profit Institute for Innovation & Valuation in Health Care in 2005, HTAs became one of the focus areas of his reseach in theory and practice, with particular emphasis on the role of health economic evaluations as an integral part of HTAs. Apart from some consulting projects – with a success rate exceeding 95%, primarily owing to a highly selective acceptance of assignments, which often were complex beyond the usual – his work in the field resulted in offers not only from global players in the biopharmaceutical industry, but also from one of the internationally leading official HTA agencies – to assume the role of (global) Head of Health Economics (cf. «Bio in Detail»). As a consequence of his determination to strive for intellectual independence, however, he stayed in academia, continuing to collaborate in consultant roles with stakeholders ranging from governments, policy-makers and HTA agencies, and payers, to hospitals, physicians, and the biopharmaceutical and medical device industries.

Some of the publicly available outcomes of his engagement in the field include

• an in-depth review of the NICE approach to HTA, as exemplified by its assessment of treatment options for attention-deficit/hyperactivity disorder (ADHD), culminating in a book with Springer (New York, NY, 2007; cf. Monographs);
• scientific leadership of a multi-stakeholder consensus project on HTA in Switzerland (»SwissHTA»);
• specific work on the challenges posed by the evaluation of orphan medicinal products (OMPs);
• the inclusion of social objectives within the value frameworks used by HTA agencies.

Further empirical work was devoted to an exploration of the potential impact of methodological choices (and underlying normative reasoning) on HTA outcomes, comparing matched pairs of HTAs by the National Institute for Health and Care Excellence (NICE), the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) and Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG), and the French Haute Autorité de Santé (HAS).

Selected Publications

1. Schlander, M.: Health Technology Assessments by the National Institute for Health and Clinical Excellence: A Qualitative Study. New York, NY: Springer, 2007.
2. Schaefer, R., Schlander, M.: Is the National Institute for Health and Care Excellence (NICE) in England more ´innovation-friendly´ than the Federal Joint Committee (GBA) in Germany? Expert Review of Pharmacoeconomics & Outcomes Research. 2019; 19(4): 453-462
3. Schaefer, R., et al.: Health technology assessment (HTA) in England, France and Germany: What do matched drug pairs tell us about recommendations by national HTA agencies? Journal of Comparative Effectiveness Research. 2021; 10(16): 1187-1195
4. Schaefer, R., et al.: Health Technology Assessment-Informed Decision Making by the Federal Joint Committee/ Institute for Quality and Efficiency in Health Care in Germany and the National Institute for Health and Care Excellence in England: The Role of Budget Impact. Value in Health. 2023; 26(7): 1032-1044
5. Schlander, M.: HTA agencies need evidence-informed deliberative processes: Comment on “Use of evidence-informed deliberative processes by health technology assessment agencies around the globe". Int J Health Policy Manag (2021); 10(3): 158-161
6. Richardson, J., Schlander, M.: Health Technology Assessment (HTA) and economic evaluation: Efficiency or fairness first. Journal of Market Access & Health Policy. 2019; 7(1): 1557981
7. Caro, J.J., ..., Schlander, M.: Determining value in Health Technology Assessment: Stay the course or tack away? PharmacoEconomics. 2019; 37(3): 293-299
8. Schlander, M., Dintsios, C.-M., Gandjour A.: Budgetary Impact and Cost Drivers for Rare and Ultrarare Diseases. Value in Health (2018); 21(5): 525-531
9. Schlander, M., Adarkwah, C.C., Gandjour A.: Budget impact analysis of drugs for ultra-orphan non-oncological diseases in Europe. Expert Review of Pharmacoeconomics & Outcomes Research, 15 (1), 2015: 171-179