Enhancing Patient Involvement in EU JCAs

By João L. Carapinha

August 6, 2025

Patient involvement in EU Joint Clinical Assessments (JCAs) is crucial for ensuring healthcare policies reflect patient needs. The article, “Patient Involvement in Health Technology Assessments: Lessons for EU Joint Clinical Assessments,” by Anne-Pierre Pickaert, compares patient involvement strategies across seven national HTA agencies. The findings show patient engagement remains inconsistent across Europe, threatening integration into the EU-wide JCA framework. The author offers recommendations to standardize and strengthen patient involvement.

Key Insights on Patient Engagement Approaches

The article highlights disparities in patient involvement terminology, structures, and processes across jurisdictions, complicating EU harmonization efforts. Leading agencies like NICE, SMC, and CDA-AMC have formalized engagement policies, support tools, and feedback mechanisms. Others, such as AIFA and AEMPS, lack formal involvement and have opaque procedures.

Meaningful participation thrives when agencies enable early input, provide continuous feedback, and maintain structured appeal mechanisms. Best practices, like including patient representatives with voting rights (seen in NICE and SMC), are rare. Resource allocation is key—agencies with dedicated budgets and staff show deeper engagement.

A gap exists in evaluating the impact of patient input on decisions. Many track participation metrics, but few assess how input influences recommendations.

Broader Context: Evidence Supporting Patient Engagement

The findings align with literature emphasizing robust patient involvement in HTA to enhance legitimacy and align with real-world needs. Systematic engagement fosters trust and transparency, improving innovation uptake. Other research shows jurisdictions linking patient input to reimbursement decisions achieve better patient-centered outcomes.

Challenges remain. Cultural, legal, and institutional differences hinder cross-border harmonization. Standardized terminology and political commitment are lacking, as shown by European patient organizations.

Implications for Health Economics, Market Access, and Policy

The findings have significant implications. Consistent patient involvement in EU JCAs could improve clinical evaluations and adoption of health technologies. Without harmonized processes, disparities may worsen if some Member States disregard patient perspectives.

Implementing the article’s suggestions—standardizing terminology, building agency capacity, and facilitating early involvement—could lead to more transparent decisions. This aligns with global HEOR trends prioritizing patient-centered frameworks.

Digital tools and centralized EU resources could reduce barriers, ensuring diverse patient voices are heard. Cross-agency knowledge sharing would spread best practices.

In conclusion, the EU JCA framework offers a chance to set benchmarks for patient-inclusive decision-making. Achieving this requires investments in guidance, resources, and evaluations, informed by national HTA experiences. Effective patient involvement is essential for equitable health outcomes in Europe.

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