Patient Engagement and Patient Experience Data in Regulatory Review and Health Technology Assessment: A Global Landscape Review

Abstract

Background: Working with patients through meaningful patient engagement (PE) and incorporating patient experience data (PXD) is increasingly important in medicines and medical device development. However, PE in the planning, organization, generation, and interpretation of PXD within regulatory and health technology assessment (HTA) decision-making processes remains challenging. We conducted a global review of the PE and PXD landscape to identify evolving resources by geography to support and highlight the potential of integration of PE and PXD in regulatory assessment and HTA.

Methods: A review of literature/public information was conducted (August 2021-January 2023), led by a multistakeholder group comprising those with lived or professional experience of PE and PXD, to identify relevant regulatory and HTA initiatives and resources reviewed and categorized by geography and focus area.

Results: Overall, 53 relevant initiatives/resources were identified (global, 14; North America, 11; Europe, 11; Asia, nine; UK, six; Latin America, one; Africa, one). Most focused either on PE (49%) or PXD (28%); few (11%) mentioned both PE and PXD (as largely separate activities) or demonstrated an integration of PE and PXD (11%).

Conclusions: Our analysis demonstrates increasing interest in PE, PXD, and guidance on their use individually in decision-making. However, more work is needed to offer guidance on maximizing the value of patient input into decisions by combining both PE and PXD into regulatory and HTA processes; the necessity of integrating PE in the design and interpretation of PXD programs should be highlighted. A co-created framework to achieve this integration is part of a future project.

Keywords: Health technology assessment; Patient engagement; Patient experience data; Real-world evidence; Regulatory assessment.

Fig. 1

Breakdown of the 13 core contributors by stakeholder group. (Please note that one of the contributors falls under both academic research and patient organization, and so is counted twice). HTA, health technology assessment; PFMD, Patient Focused Medicines Development

Fig. 2

Case study of patient contributions to scientific advice provided by the EMA. The number of patient contributions and how they contributed to various aspects of scientific advice provided by the EMA was assessed as part of a 4-year case study. *In most cases where patient input did not make a change, most of the patients agreed with the development plan set out. EMA, European Medicines Agency