In their article published in Health Economics, Policy and Law by Cambridge University Press, Filippos Papadopoulos, Erica Visintin, Ilias Kyriopoulos, and Panos Kanavos explore the reasons why certain drugs fail health technology assessments (HTAs) across seven OECD countries. Unlike much of the existing research, which focuses on factors driving positive HTA outcomes, this study provides a rare comparative analysis of HTA rejections. Drawing on a dataset of 1,405 HTA reports from 2009 to 2020, the authors investigate how regulatory, clinical, and economic factors contribute to the likelihood of a drug being rejected.
Their findings reveal that 12.9% of HTA submissions were rejected, with particularly high rates for cancer and orphan drugs, as well as those supported by low-quality evidence or marked by uncertainty in cost-effectiveness models. The authors also identify systematic differences between national HTA agencies, underscoring the need for greater cross-border collaboration, improved evidence standards, and more consistent evaluation practices.