How do qualitative methods fit into HTA processes?

Qualitative research can make an important contribution to health technology assessment. This can involve the identification and review of qualitative evidence (qualitative evidence synthesis) aimed at explaining differences in intervention effect, to explore aspects of implementation or to capture evidence of the needs and views of patients, patient experience or preference[1][2]. Especially for the latter, qualitative research can provide strong evidence and help decision-makers and developers of medicines to incorporate these in their deliberations . It can also be used to guide larger societal decisions about how to allocate limited available resources. Some questions that are important for research and reimbursement decision-making may illustrate this:

  • Should we value care for the very sick or the very old more than others?
  • How should we value technologies that reduce interactions with doctors and caregivers?
  • Are there reasons that help explain sub-optimal use of medicines in practice?

Quantitative research can help us understand:

  • How many people are affected by a disease;
  • What the economic burden of a disease is;
  • How many people might benefit from a particular medicine;
  • What the value of the benefit is;
  • How often the medicine might be used once access is provided.

These are all important aspects to consider for decision-making.

The list below gives just a few examples where qualitative research can play a role.

Medicines development

  • What diseases are important to address
  • What is the need for new medicines
  • Which outcomes are of importance
  • What are adequate Patient Reported Outcome Measures (PROMs) and Health Related Quality of Life (HRQoL) measures.

Reimbursement and decision-making

  • Determine need for existing medicine
  • Identify possible problems with alternatives
  • social values to guide decision-making.


Implementation delivery and impact

  • Evaluate reasons for suboptimal adherence
  • Explore how patient experiences can be optimised
  • Determine other factors to be taken into account.

For all of the above robust patient input is important to ensure, that the patient perspective is considered in decision making.

[1] Media Watch|Book| Volume 10, ISSUE 4, P226, April 01, 2010 Systematic reviews: CRD's guidance for undertaking reviews in health care, Evelina Tacconelli Published:April, 2010 DOI:

[2] Booth A. Qualitative evidence synthesis. In: Facey K, PlougHansen H, Single A, editors. Patient Involvement in Health Technol-ogy Assessment. Singapore: Adis; 2017:187-199.