Population-adjusted treatment comparisons in Health Technology Assessment: an overview of approaches and perspectives

David Phillippo, Ahmed Elsada, Mark Belger, Nicky Welton

Research output: Contribution to conferenceConference Abstractpeer-review


PURPOSE: This workshop will: (i) provide an overview of population adjustment methods and outline recommendations for their use in Health Technology Assessment (HTA); (ii) present industry and reimbursement agency perspectives and practical experiences. DESCRIPTION: Treatment comparisons without head-to-head trials are frequently formed using indirect comparisons across multiple trials, making the assumption that any effect modifiers are balanced between trials. Recently proposed methods which relax this assumption, including Matching-Adjusted Indirect Comparison (MAIC) and Simulated Treatment Comparison (STC), are becoming increasingly common in industry-sponsored treatment comparisons, where a company has individual patient data (IPD) from its own trials but only aggregate data from competitor trials. These methods aim to adjust for between-trial differences to form population-adjusted indirect comparisons, and may even be used for comparisons involving single arm studies or disconnected networks. However, additional assumptions and complexities are introduced which must be carefully considered. Since the premise of population adjustment methods is that relative treatment effects can differ between populations, a core component of population adjustment in HTA is the definition of and adjustment to a specific target population for the decision; reimbursement agencies must consider the implications of this change in the decision scenario, whilst companies making submissions must be prepared to produce and justify a comparison in the correct target population. This workshop will begin with an overview of population adjustment methods. Their assumptions and additional considerations over standard indirect comparisons will be explained along with recommendations on their use in HTA, drawing from a recently published NICE Decision Support Unit Technical Support Document. Following this, presentations from industry and reimbursement agency perspectives will explore the role of population adjustment in HTA through practical examples, providing insight on the experiences and challenges of the use of these new methods in HTA. The workshop will conclude with an interactive Q&A session.
Original languageEnglish
Publication statusUnpublished - 8 Nov 2017
EventISPOR 20th Annual European Congress - Scottish Event Campus, Glasgow, United Kingdom
Duration: 4 Nov 20178 Nov 2017


ConferenceISPOR 20th Annual European Congress
Country/TerritoryUnited Kingdom


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