Announcements

Current & archive
CAR-T cell therapy: Updated effectiveness and safety results from real-world evidence: A systematic review
CAR-T cell therapy, a personalized form of immunotherapy for certain blood cancers, is gaining global relevance. This review analyzed real-world data from 26 studies (2,716 patients) on six EMA-approved CAR-T products. Results show that real-world outcomes are generally comparable to clinical trials, with better results than non-CAR-T treatments. However, due to study limitations and risk of bias, the effectiveness and safety of CAR-T therapy remain uncertain. Longer follow-ups and broader indications offer new insights but highlight the need for more robust evidence.
Publication: HTA Project Report No. 166: https://eprints.aihta.at/1562/
Contact: Ingrid Zechmeister-Koss
Teprotumumab (TEPEZZA®) for moderate-to-severe thyroid eye disease
Teprotumumab (TEPEZZA®) is a human monoclonal antibody targeting the insulin-like growth factor 1 receptor (IGF-1R), blocking its activation and signalling. Thereby, it prevents symptoms of moderate-to-severe thyroid eye disease (TED, Graves´ orbitopathy), including lid retraction, soft tissue involvement, proptosis and diplopia. Currently, teprotumumab is under evaluation by the European Medicines Agency (EMA) for market authorisation and is expected to be approved by the European Commission (EC) in July 2025. Compared to placebo, teprotumumab significantly improved proptosis response, clinical activity score (CAS), and Graves’ ophthalmopathy-specific quality-of-life scores in three clinical studies and one observational study. The most frequent adverse events included muscle spasms, alopecia, nausea and fatigue. Additionally, 12-15% of teprotumumab patients reported (partially irreparable) hearing damage. TED reactivation rates varied from 26% to 29%, and 65.4% of patients experienced a regression. Notably, 33% of patients maintained a sustained response through the 24-month follow-up. The available evidence is limited, as efficacy has only been tested against a placebo, not the standard of care.
Publication: Decision Support Document for the Austrian Appraisal Board No. 003: https://eprints.aihta.at/1560/
Contact: AIHTA Bewertungsboard Team: bewertungsboard@aihta.at
Fidanacogene elaparvovec (BEQVEZ®) for the treatment of moderate and severe haemophilia B
Fidanacogene elaparvovec (BEQVEZ®) received conditional marketing authorisation from the European Commission on 24th July 2024 for treating severe and moderate haemophilia B. It is the second gene therapy approved in Europe for this condition and is classified as an Advanced Therapy Medicinal Product (ATMP). This gene therapy is approved for adults with no history of factor IX inhibitors and no detectable antibodies against AAVRh74var. It is administered as a one-time intravenous infusion and uses a viral vector to introduce the functioning coagulation factor IX gene into liver cells, where it continuously produces the missing factor.
Fidanacogene elaparvovec demonstrated a 71% reduction in annual bleeding rate compared to previous FIX prophylaxis in a single-arm Phase 3 study (BENEGENE-2, n=45). The effect was maintained for up to 48 months. Adverse effects occurred in 84% of patients treated, with 16% experiencing serious reactions. The most common side effect was elevated aminotransferase levels (53%). The study's methodological limitations include a short follow-up period, a lack of a control group, and changes to the primary endpoint. As the therapy is administered only once intravenously, interviewed patients express optimism about the reduced treatment burden and improved quality of life that may result from a simplified form of therapy and freedom from treatment. At the same time, patients are concerned about the uncertainty regarding long-term efficacy and potential side effects. Therefore, it is recommended that patients receive an infusion in specialised centres with subsequent monitoring in local facilities. Additionally, mandatory follow-up of all treated patients is deemed necessary.
In Austria, 130 patients were reported by the Austrian Haemophilia Society (ÖHR) in 2024. Of these, 22.3% were affected by moderate haemophilia and 24.6% by severe haemophilia. Currently, no price for fidanacogene elaparvovec is available in Europe, so the budget impact analysis (BIA) was based on a preliminary price of 3.4 million euros per administration. Assuming nine patients receive the therapy with an increasing uptake over three years (year 1: 20%, year 2: 30%, year 3: 50%), the total three-year budget impact would amount to approximately 41 million euros. This represents a 3-fold increase compared to the current treatment. In the long term (after about 12 years), costs could be offset by the elimination of prophylaxis.
Publication: Decision Support Document for the Austrian Appraisal Board No. 002:
https://eprints.aihta.at/1558/
Contact: Sarah Wolf
Exagamglogene autotemcel (Exa-cel, Casgevy®) for the treatment of beta-thalassemia and severe sickle cell disease
Exagamglogene autotemcel (exa-cel, Casgevy®) received conditional marketing authorization from the European Medicines Agency (EMA) on February 9, 2024, as the first CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-based gene therapy. It is classified as an Advanced Therapy Medicinal Product (ATMP) and has orphan drug status for two indications. Exa-cel is approved for treating transfusion-dependent ß-thalassemia (TDT) and severe sickle cell disease (SCD) in patients aged twelve years or older who are eligible for hematopoietic stem cell transplantation but lack a human leukocyte antigen (HLA)-matched related donor.
The studies to date (two single-arm studies) show a significant improvement in symptoms in the majority of patients treated. In beta-thalassemia, 32 out of 35 people no longer needed blood transfusions after the therapy. In sickle cell disease, 29 out of 30 patients no longer had severe pain crises. These improvements lasted for at least one to two years in both diseases. The patients' quality of life was noticeably improved as a result. Long-term experience is not yet available.
Publication: Decision Support Document for the Austrian Appraisal Board No. 001:
https://eprints.aihta.at/1548/
Contact: Nicole Grössmann-Waniek
ASSESS-DHT: Telehealth in Diabetes: EU mapping and systematic evaluation of organizational aspects
The number of people living with diabetes is increasing globally, with approximately 90% having Type 2 Diabetes Mellitus (T2DM). The fundamental management of T2DM relies on maintaining a healthy lifestyle. This includes regular medical visits for monitoring, balanced diet management, regular exercise, and maintaining a healthy body weight. Telehealth has gained attention as a means of supporting the continuous self-management and treatment of people living with diabetes.
This report focuses on diabetes telehealth programs currently available or being piloted in European countries. It examines their organizational aspects based on findings from a scoping review and a questionnaire survey.
Publication: HTA Project Report No. 161: https://eprints.aihta.at/1555/
Contact: Yui Hidaka
Horizon Scanning in Oncology - Fact Sheets
We are pleased to introduce you five new Fact Sheets.
Fact Sheet No. 191 (September 2024)
Daratumumab (Darzalex®) with bortezomib, lenalidomide and dexamethasone for the treatment of newly diagnosed multiple myeloma (MM)
Fact Sheet No. 192 (September 2024)
Serplulimab (Hetronifly®) with carboplatin and etoposide for the first?line treatment of extensive?stage small cell lung cancer (ES-SCLC)
Fact Sheet No. 193 (September 2024)
Mirvetuximab soravtansine (Elahere®) for the treatment of adults with folate receptor-alpha (FR?) positive epithelial ovarian, fallopian tube and primary peritoneal cancer
Fact Sheet No. 194 (September 2024)
Pembrolizumab (Keytruda®) with chemoradiotherapy (CRT) for the treatment of FIGO 2014 Stage III - IVA locally advanced cervical cancer
Fact Sheet No. 195 (September 2024)
Pembrolizumab (Keytruda®) for the treatment of adults with endometrial carcinoma
Threshold values in health economic evaluations and decision-making
Healthcare systems worldwide face the challenge of optimising resource allocation and maximising health benefits through their funding decisions.
This report examines how healthcare systems approach resource allocation through incremental cost-effectiveness ration (ICER) thresholds. Through analysis of literature, policy documents, and health economic guidelines from various countries, the research explores theoretical foundations and practical applications of these thresholds. The findings reveal significant variations in threshold implementation across countries and show important relationships between thresholds and health system outcomes. The research also identifies key factors for implementation. This report offers insights into how threshold implementation can enhance healthcare system transparency and efficiency when adapted to national contexts.
Publication: HTA Project Report No. 163: https://eprints.aihta.at/1549/
Contact: Christoph Strohmaier
Artificial Intelligence in health care with a focus on hospitals: Methodological considerations for Health Technology Assessment. A Scoping Review.
Artificial Intelligence (AI) in healthcare comprises machine-based systems designed to imitate human cognitive abilities and is increasingly important in digital health technologies. An analysis of 51 Health Technology Assessment (HTA) institutions revealed that 13 institutions published a total of five methodological documents and 30 HTA reports, primarily focusing on diagnostic and screening applications (27/30), which mainly serve as support tools and require medical personnel decision-making.
The analysis shows that standard HTA methods can serve as a starting point for evaluation, but AI-specific considerations are required for technical, ethical, and organisational aspects as well as implementation monitoring. The latter is particularly important as algorithms can change and need regular evaluation. Regulatory compliance requires adherence to the EU AI Act, Medical Device Regulation and General Data Protection Regulation. A mature digital infrastructure with high interoperability is considered a fundamental prerequisite for successful implementation.
Publication: HTA Project Report No. 164: https://eprints.aihta.at/1546/
Contact: Michaela Riegelnegg
Strategies for reducing weight stigmatisation towards people with overweight or obesity in the healthcare system
Every second person who is overweight or obese is generally affected by stigmatisation due to their body weight. The healthcare sector is cited as one of the most common causes. As a result, the affected patients may receive incorrect or no diagnoses and therapies, avoid examinations and suffer health consequences such as further weight gain. Through a systematic literature search, various guideline-based recommendations for reducing weight stigma towards overweight and obese people in healthcare settings were identified. Further, available evidence for investigated interventions was analysed.
Publication: HTA Project Report No. 160: https://eprints.aihta.at/1547/
Contact: Sarah Wolf
Oncological Breast Cancer Care in Selected European Countries- Cross-sectoral cancer care models
The increasing incidence and prevalence of cancer, particularly breast cancer, presents substantial challenges for the Austrian healthcare system. The current hospital-centred care delivery model contributes to escalating costs and suboptimal resource utilisation.
A comprehensive analysis of cancer care models across six European countries (Austria [AT], Germany [DE], Denmark [DK], Sweden [SE], Netherlands [NL], Belgium [BE]) was conducted through structured literature review, expert consultations (n=17), and data synthesis, focusing specifically on breast cancer care. Analysis of healthcare infrastructures and cross-sectoral care approaches throughout the patient journey identified three distinct models: centralised specialist models (AT, BE, DK) characterised by highly specialised centres with strict volume requirements; decentralised care (DE) featuring distributed hospital structures in the in- and outpatient setting; and network-based integrated care (NL, SE) combining specialist centres with regional care delivery. These models demonstrate considerable variations in their utilisation of inpatient, outpatient, and home-based care services. While these models reflect varying degrees of centralisation and specialisation, they all aim to ensure high-quality care through regulation, accreditation and collaboration, with countries combining elements of different models based on their national cancer strategy and healthcare infrastructure.
For Austria, implementing a gradual transition towards a more decentralised or network-based model could potentially alleviate pressure on hospital resources while enhancing quality of care. However, successful implementation necessitates appropriate infrastructure, qualified healthcare professionals, and effective cross-sectoral coordination. Key challenges include addressing workforce shortages and overcoming fragmented data integration across healthcare sectors.
Publication: HTA Project Report No. 162: https://eprints.aihta.at/1545/
Contact: Nicole Grössmann-Waniek