title: European collaboration on relative effectiveness assessments: What is needed to be successful?
abstract: OBJECTIVE
  The objective of this study is to identify the possible barriers and critical success factors for the implementation of European collaboration in the field of relative effectiveness assessment (REA) of drugs.
  
  
  METHODS
  Data were gathered through semi-structured interviews with representatives from eight European health technology assessment (HTA) organisations involved in assessment of drugs for coverage decision-making (AAZ, AIFA, AHTAPol, HAS, HVB, IQWIG, NICE and ZiN).
  
  
  RESULTS
  Potential barriers identified mainly relate to methodology, resources and challenges with implementation in the respective national processes (e.g. legal restrictions). The most critical success factors for production of cross-border assessments were the continuous cooperation of competent partners, and the quality and timely availability of the assessment.
  
  
  CONCLUSIONS
  Further adaptation of the process and methods is required for optimal collaboration. In the near future it can be expected that cross-border assessments will meet in particular the needs of smaller/middle-sized European countries and also European countries with less developed HTA systems as the potential efficiency/quality gains are the highest for these countries. Therefore, national implementation of cross-border assessments is especially likely in these countries in the coming years. Once more experience is gained with cross-border assessments, and successes become more evident, efficiency/quality gains may also be likely for some larger countries with well established processes.
authors.affiliation: National Health Care Institute (Zorginstituut Nederland), PO Box 320, 110 XH Diemen, The Netherlands; University of Utrecht, PO Box 80082, 3508 TB Utrecht, The Netherlands. Electronic address: skleijnen@zinl.nl.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kleijnen
authors.affiliation: ToendersdeGroot Consultants, Boomstede 281, 3608 AN Maarssen, The Netherlands.
authors.forename: Wil
authors.initials: W
authors.lastname: Toenders
authors.affiliation: ToendersdeGroot Consultants, Boomstede 281, 3608 AN Maarssen, The Netherlands.
authors.forename: Folkert
authors.initials: F
authors.lastname: de Groot
authors.affiliation: Agency for Quality and Accreditation in Health Care and Social Welfare (Agencija za kvalitetu i akreditaciju u zdravstvu i socijalnoj skrbi), Planinska 13, HR-10000 Zagreb, Croatia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Huic
authors.affiliation: National Institute for Health and Care Excellence, 10 Spring Gardens, London SW1A 2BU, England, United Kingdom.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: George
authors.affiliation: The Institute for Quality and Efficiency in Healthcare (Institut für Qualität und Wirtschaftlichkeit im Gesundheidswesen), Im Mediapark 8, D-50670 Köln, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Wieseler
authors.affiliation: French National Authority for Health (Haute Autorité de Santé), 2, avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France.
authors.forename: Mira
authors.initials: M
authors.lastname: Pavlovic
authors.affiliation: Association of Austrian Social Insurance Institutions (Hauptverband der Österreichischen Sozialversicherungsträger), Postfach 600, 1031 Vienna, Austria; University of Vienna, Brünner Straße 72, 1210 Vienna, Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Bucsics
authors.affiliation: Italian Medicines Agency (Agenzia Italiana del Farmaco), Via del Tritone, 181, 00187 Rome, Italy.
authors.forename: Paolo D
authors.initials: PD
authors.lastname: Siviero
authors.affiliation: National Health Care Institute (Zorginstituut Nederland), PO Box 320, 110 XH Diemen, The Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: van der Graaff
authors.affiliation: Agency for Health Technology Assessment and Tariff System in Poland (Agencja Oceny Technologii Medycznych i Taryfikacji), ul. I. Krasickiego 26, 02-611 Warsaw, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Rdzany
authors.affiliation: Danish Health and Medicines Authority (Sundhedsstyrelsen), Axel Heides Gade 1, 2300 Copenhagen S, Denmark; University of Southern Denmark, Campusvej 55, DK 5230 Odense M, Denmark.
authors.forename: Finn Børlum
authors.initials: FB
authors.lastname: Kristensen
authors.affiliation: National Health Care Institute (Zorginstituut Nederland), PO Box 320, 110 XH Diemen, The Netherlands; University of Utrecht, PO Box 80082, 3508 TB Utrecht, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Goettsch
mesh_terms: D057186:Comparative Effectiveness Research; D003430:Cross-Sectional Studies; D004341:Drug Evaluation / Q000379:methods; D005060:Europe; D006801:Humans; D007391:International Cooperation; D017146:Models, Organizational; D004364:Pharmaceutical Preparations / Q000592:standards; D000091402:Prohibitins; D036301:Qualitative Research; D011795:Surveys and Questionnaires
chemical_list: C000717331:PHB2 protein, human; D004364:Pharmaceutical Preparations; D000091402:Prohibitins
keywords: European collaboration; Health technology assessment; Pharmaceuticals; Reimbursement; Relative effectiveness; Relative effectiveness assessment