{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:53:03Z","timestamp":1776750783027,"version":"3.51.2"},"reference-count":103,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1SE9425N"],"award-info":[{"award-number":["1SE9425N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patient and public involvement (PPI) in pricing and reimbursement (P&amp;amp;R) procedures is increasingly recognized as essential for strengthening the quality, legitimacy, and patient-centredness of healthcare decision-making. However, implementation remains heterogeneous across countries and data on concrete practices, barriers, and enablers are fragmented. This study aimed to map international approaches to PPI in P&amp;amp;R procedures and identify barriers and enablers to meaningful involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-methods design was applied, combining a scoping literature review complemented by qualitative research. The scoping literature review was conducted following PRISMA-ScR guidance to identify scientific publications on PPI in P&amp;amp;R procedures. Semi-structured interviews and focus group discussions were conducted with industry experts, policymakers, assessors, and patient organisations. A descriptive, narrative, and thematic analysis integrating findings across data sources identified recurring patterns, cross-country similarities and differences, and diverse stakeholders\u2019 perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The literature and stakeholder perspectives revealed that PPI remains uneven and inconsistently implemented in P&amp;amp;R procedures across healthcare systems, though overall trends point towards more structured participation and partnership. Barriers include: (i) resource constraints, (ii) unclear value and impact of PPI, (iii) conflict of interest and confidentiality concerns, (iv) recruitment challenges, (v) concerns about representativeness and diversity, (vi) complexity of P&amp;amp;R terminology and processes, (vii) methodological gaps, (viii) limited experience with PPI, and (ix) competing workloads. Across countries, stakeholders identified a shared set of enabling conditions necessary for meaningful involvement: (i) clear institutional commitment and leadership, (ii) dedicated resources, time, and experience-building with explicit definition of roles, expectations, and scope of influence, (iii) transparency and systematic feedback for two-way communication, (iv) methodological rigour and evaluation frameworks for capturing and reporting experiential evidence, (v) inclusivity and representativeness with diverse participation opportunities, and (vi) capacity building for both patients and the public, as well as P&amp;amp;R agencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While PPI in P&amp;amp;R procedures remains uneven across countries, there is a clear shift towards more structured participation. Meaningful and sustainable involvement requires the integration of structural, organisational, procedural, technical, and financial enablers. When these enablers are aligned and mutually reinforcing, PPI can become a substantive driver of more patient-centred, transparent, and socially accountable P&amp;amp;R decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1791567","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:34:06Z","timestamp":1776749646000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["International practices, barriers, and enablers for patient and public involvement in pricing and reimbursement decision-making: a mixed-methods study"],"prefix":"10.3389","volume":"17","author":[{"given":"Alice","family":"Vanneste","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgane","family":"Deknudt","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Schoefs","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Verbeke","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Sinnaeve","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven","place":["Leuven, Belgium"]},{"name":"Department of Cardiovascular Medicine, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane-Estelle","family":"Ngatchou-Djomo","sequence":"additional","affiliation":[{"name":"Belgian umbrella patient organisation, Ligue des Usagers des Services de Sant\u00e9 (LUSS)","place":["Namur, Belgium"]},{"name":"Department of Health Economics, United Nations University \u2013 Maastricht Economic and Social Research Institute on Innovation and Technology","place":["Maastricht, Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Hlav\u00e1\u010dov\u00e1","sequence":"additional","affiliation":[{"name":"International Relations and EU Unit, Ministry of Health of the Czech Republic","place":["Prague, Czechia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Huys","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Adriaenssens","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven","place":["Leuven, Belgium"]},{"name":"Department of Cardiovascular Medicine, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.healthpol.2006.07.009","article-title":"Bringing 'the public' into health technology assessment and coverage policy decisions: from principles to practice","volume":"82","author":"Abelson","year":"2007","journal-title":"Health Policy"},{"key":"B2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1017\/S0266462313000299","article-title":"Assessing the impacts of citizen deliberations on the health technology process","volume":"29","author":"Abelson","year":"2013","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B3","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1017\/S0266462316000362","article-title":"Public and patient involvement in health technology assessment: a framework for action","volume":"32","author":"Abelson","year":"2016","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"103093","DOI":"10.1016\/j.arcmed.2024.103093","article-title":"Design and implementation of a stakeholder consultation process for rapid health technology assessments in Argentina","volume":"56","author":"Alcaraz","year":"2025","journal-title":"Arch. Med. Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s41927-023-00327-w","article-title":"Patient and public involvement in research: a review of practical resources for young investigators","volume":"7","author":"Arumugam","year":"2023","journal-title":"BMC Rheumatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e70119","DOI":"10.1111\/hex.70119","article-title":"Involving patients in hospital-based health technology assessment of innovative medical devices: adapting to a specific local context and lessons learned from the assessment of an Ex Vivo perfusion system of human donor hearts","volume":"27","author":"Atfeh","year":"2024","journal-title":"Health Expect."},{"key":"B7","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1093\/jphsr\/rmab050","article-title":"Giving patients a voice in health technology assessment decision-making in Greece: a patient advocacy group consensus analysis","volume":"12","author":"Athanasakis","year":"2021","journal-title":"J. Pharm. Health Serv. Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s40900-016-0036-9","article-title":"Patients' perspectives can be integrated in health technology assessments: an exploratory analysis of CADTH common drug review","volume":"2","author":"Berglas","year":"2016","journal-title":"Res. Involv Engagem."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1017\/S0266462321000088","article-title":"An institutional ethnographic analysis of public and patient engagement activities at a national health technology assessment agency","volume":"37","author":"Bidonde","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B10","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1215\/03616878-7530825","article-title":"Getting to the table: changing ideas about public and patient involvement in Canadian drug assessment","volume":"44","author":"Boothe","year":"2019","journal-title":"J. Health Polit. Policy Law"},{"key":"B11","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1017\/S1744133121000013","article-title":"(Re)defining legitimacy in Canadian drug assessment policy? Comparing ideas over time","volume":"16","author":"Boothe","year":"2021","journal-title":"Health Econ. Policy Law"},{"key":"B12","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1111\/j.1369-7625.2012.00795.x","article-title":"Mapping the impact of patient and public involvement on health and social care research: a systematic review","volume":"17","author":"Brett","year":"2014","journal-title":"Health Expect."},{"key":"B13","article-title":"Involvement of patients of healthcare systems in health technology assessment (HTA): a narrative review of international strategies","volume":"22","author":"Castro","year":"2018","journal-title":"Interface Comun. Sa\u00fade Educ."},{"key":"B14","volume-title":"Nothing about us without us: disability, oppression and empowerment","author":"Charlton","year":"1998"},{"key":"B15","doi-asserted-by":"publisher","first-page":"732160","DOI":"10.3389\/fmedt.2021.732160","article-title":"Patient involvement in the health technology assessment process in Taiwan","volume":"3","author":"Chen","year":"2021","journal-title":"Front. Med. Technol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1017\/S0266462320000513","article-title":"Developing an agency's position with respect to patient involvement in health technology assessment: the importance of the organizational culture","volume":"36","author":"Cleemput","year":"2020","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B17","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.jval.2014.12.015","article-title":"Acceptability and perceived benefits and risks of public and patient involvement in health care policy: a Delphi survey in Belgian stakeholders","volume":"18","author":"Cleemput","year":"2015","journal-title":"Value Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1017\/S0266462321000167","article-title":"Development of an international template to support patient submissions in health technology assessments","volume":"37","author":"Cook","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e59","DOI":"10.1017\/S0266462325100408","article-title":"Plain language summaries supporting patient involvement: lessons and guidance from HTAi patient and citizen involvement interest group (PCIG)","volume":"41","author":"Coombes","year":"2025","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"k4738","DOI":"10.1136\/bmj.k4738","article-title":"Impact of patient and public involvement on enrolment and retention in clinical trials: systematic review and meta-analysis","volume":"363","author":"Crocker","year":"2018","journal-title":"Bmj"},{"key":"B21","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s12961-023-01018-1","article-title":"Does patient and public involvement impact public health decision-making? A 10 year retrospective analysis of public consultation in Brazil","volume":"21","author":"De Freitas Lopes","year":"2023","journal-title":"Health Res. Policy Syst."},{"key":"B22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3390\/jmahp12010004","article-title":"An inclusive civil society dialogue for successful implementation of the EU HTA regulation: call to action to ensure appropriate involvement of stakeholders and collaborators","volume":"12","author":"Desmet","year":"2024","journal-title":"J. Mark. Access Health Policy"},{"key":"B23","doi-asserted-by":"publisher","first-page":"922708","DOI":"10.3389\/fpubh.2022.922708","article-title":"Potential barriers of patient involvement in health technology assessment in central and eastern European countries","volume":"10","author":"Dimitrova","year":"2022","journal-title":"Front. Public Health"},{"key":"B24","first-page":"217","article-title":"Patient participation in the assessment of alternatives to restraint and seclusion","volume":"26","author":"Dipankui","year":"2014","journal-title":"Sante Publique"},{"key":"B25","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1017\/S0266462315000240","article-title":"Evaluation of patient involvement in a health technology assessment","volume":"31","author":"Dipankui","year":"2015","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B26","unstructured":"Patient involvement in HTA: can we learn from past experiences across Europe?\n          \n          \n          2024"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e24","DOI":"10.1017\/S0266462320002226","article-title":"Patient involvement in relative effectiveness assessments in the european network for health technology assessment","volume":"37","author":"Elvsaas","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B28","unstructured":"Reflection paper on patient experience data\n          \n          \n          2025"},{"key":"B29","volume-title":"Patient involvement in health technology assessment in Europe: results of the EPF survey","year":"2013"},{"key":"B30","unstructured":"Briefing on health technology assessment in the european union"},{"key":"B31","volume-title":"10 key recommendations from patient organisations on joint clinical assessments under the EU HTA regulation","year":"2024"},{"key":"B32","unstructured":"EPF position on the European commission\u2019s proposal for a regulation on health technology assessment"},{"key":"B33","volume-title":"About HTA","year":"2025"},{"key":"B77","unstructured":"Strategy for EU cooperation on health technology assessment\n          \n          \n          2014"},{"key":"B34","volume-title":"EUPATI open classroom","year":"2025"},{"key":"B35","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1017\/S0266462310000395","article-title":"Patients' perspectives in health technology assessment: a route to robust evidence and fair deliberation","volume":"26","author":"Facey","year":"2010","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B36","unstructured":"FDA patient-focused drug development guidance series for enhancing the incorporation of the patient\u2019s voice in medical product development and regulatory decision making\n          \n          \n          2025"},{"key":"B37","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1017\/S0266462310001315","article-title":"Introducing patients' and the public's perspectives to health technology assessment: a systematic review of international experiences","volume":"27","author":"Gagnon","year":"2011","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B38","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1472-6963-12-14","article-title":"Involving patients in HTA activities at local level: a study protocol based on the collaboration between researchers and knowledge users","volume":"12","author":"Gagnon","year":"2012","journal-title":"BMC Health Serv. Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1111\/hex.12010","article-title":"Introducing the patient's perspective in hospital health technology assessment (HTA): the views of HTA producers, hospital managers and patients","volume":"17","author":"Gagnon","year":"","journal-title":"Health Expect."},{"key":"B40","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/1472-6963-14-273","article-title":"Involving patient in the early stages of health technology assessment (HTA): a study protocol","volume":"14","author":"Gagnon","year":"","journal-title":"BMC Health Serv. Res."},{"key":"B41","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1017\/S0266462315000070","article-title":"Framework for user involvement in health technology assessment at the local level: views of health managers, user representatives, and clinicians","volume":"31","author":"Gagnon","year":"2015","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e36","DOI":"10.1017\/S0266462321000064","article-title":"Patient and public involvement in health technology assessment: update of a systematic review of international experiences","volume":"37","author":"Gagnon","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.1016\/j.socscimed.2010.01.036","article-title":"It all depends: conceptualizing public involvement in the context of health technology assessment agencies","volume":"70","author":"Gauvin","year":"2010","journal-title":"Soc. Sci. Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1017\/S0266462310001200","article-title":"Moving cautiously: public involvement and the health technology assessment community","volume":"27","author":"Gauvin","year":"2011","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B45","doi-asserted-by":"publisher","first-page":"5","DOI":"10.2478\/amb-2021-0028","article-title":"Role of the patient\u2018s viewpoint in health technologies assessment in Bulgaria","volume":"48","author":"Georgieva","year":"2021","journal-title":"Acta Medica Bulg."},{"key":"B46","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1017\/S0266462323000132","article-title":"A HTA of what? Reframing through including patient perspectives in health technology assessment processes","volume":"39","author":"Gunn","year":"2023","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B47","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1017\/S0266462306051427","article-title":"Survey on the involvement of consumers in health technology assessment programs","volume":"22","author":"Hailey","year":"2006","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B48","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1017\/S026646231200075X","article-title":"Involvement of consumers in health technology assessment activities by inahta agencies","volume":"29","author":"Hailey","year":"2013","journal-title":"Int. J. Technol. Assess. Health Care."},{"key":"B49","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/j.sapharm.2015.12.005","article-title":"Incorporating patient perspectives in health technology assessments and clinical practice guidelines","volume":"12","author":"H\u00e4meen-Anttila","year":"2016","journal-title":"Res. Soc. Adm. Pharm."},{"key":"B50","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1111\/hex.12594","article-title":"Decision making in NICE single technological appraisals: how does NICE incorporate patient perspectives?","volume":"21","author":"Hashem","year":"2018","journal-title":"Health Expect."},{"key":"B51","unstructured":"Patient involvement in HTA in Europe: recommendations from a 360\u00b0 perspective view of current patient involvement practices\n          \n          \n            \n              Holtorf\n              A. P.\n            \n            \n              Bertelsen\n              N.\n            \n          \n          \n          2023"},{"key":"B52","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1017\/S0266462320002263","article-title":"Pilot approach to analyzing patient and citizen involvement in health technology assessment in four diverse low- and middle-income countries","volume":"37","author":"Holtorf","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B53","doi-asserted-by":"publisher","first-page":"e81","DOI":"10.1017\/S0266462324004707","article-title":"Stakeholder perspectives on the current status and potential barriers of patient involvement in health technology assessment (HTA) across Europe","volume":"40","author":"Holtorf","year":"2024","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B54","volume-title":"ICH reflection paper - proposed ICH guideline work to advance patient focused drug development (PFDD)","year":"2021"},{"key":"B55","volume-title":"INAHTA position statement patient involvement","year":"2021"},{"key":"B56","volume-title":"HTA glossary","year":"2025"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1176200","DOI":"10.3389\/fpubh.2023.1176200","article-title":"Recommendations for patient involvement in health technology assessment in central and eastern european countries","volume":"11","author":"Jakab","year":"2023","journal-title":"Front. Public Health"},{"key":"B58","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3389\/fmed.2018.00285","article-title":"Patient involvement in the lifecycle of medicines according to Belgian stakeholders: the gap between theory and practice","volume":"5","author":"Janssens","year":"2018","journal-title":"Front. Med. (Lausanne)"},{"key":"B59","doi-asserted-by":"publisher","first-page":"e70109","DOI":"10.1111\/hex.70109","article-title":"Exploring barriers and facilitators to patients and members of the public contributing to rapid health technology assessments for NICE: a qualitative study","volume":"27","author":"Johnson","year":"2024","journal-title":"Health Expect."},{"key":"B60","volume-title":"Patients\u2019 associations and HTA for medicines: actual and future role in Italy","author":"Jommi","year":"2018"},{"key":"B61","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1017\/S0266462314000282","article-title":"Patient perspective in health technology assessment of pharmaceuticals in finland","volume":"30","author":"Kleme","year":"2014","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B62","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1215\/03616878-1898812","article-title":"Public engagement in health technology assessment and coverage decisions: a study of experiences in France, Germany, and the United Kingdom","volume":"38","author":"Kreis","year":"2013","journal-title":"J. Health Polit. Policy Law"},{"key":"B63","volume-title":"Qualitative research analysis","author":"Lacey","year":"2007"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1016\/j.jval.2022.03.021","article-title":"Involvement of patients and medical professionals in the assessment of relative effectiveness: a need for closer cooperation","volume":"25","author":"Lips","year":"2022","journal-title":"Value Health"},{"key":"B65","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1017\/S0266462320002214","article-title":"Evaluation of the impact of patient input in health technology assessments at NICE","volume":"37","author":"Livingstone","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B66","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1111\/hex.12356","article-title":"Involving patients in health technology funding decisions: stakeholder perspectives on processes used in Australia","volume":"19","author":"Lopes","year":"2016","journal-title":"Health Expect."},{"key":"B67","doi-asserted-by":"publisher","first-page":"136","DOI":"10.11606\/s1518-8787.2020054002453","article-title":"Patient and public involvement in health technology decision-making processes in Brazil","volume":"54","author":"Lopes","year":"","journal-title":"Rev. Saude Publica"},{"key":"B68","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1017\/S0266462320000537","article-title":"The rationale and design of public involvement in health-funding decision making: focus groups with the Canadian public","volume":"36","author":"Lopes","year":"","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B69","doi-asserted-by":"publisher","first-page":"e52","DOI":"10.1017\/S0266462324000400","article-title":"The three-domain impact framework for characterizing impact of patient involvement in health technology assessment","volume":"40","author":"Lopez Gousset","year":"2024","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B70","doi-asserted-by":"publisher","first-page":"23743735221125439","DOI":"10.1177\/23743735221125439","article-title":"Impact of patient engagement on healthcare quality: a scoping review","volume":"9","author":"Marzban","year":"2022","journal-title":"J. Patient Exp."},{"key":"B71","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1586\/erp.10.82","article-title":"Role of patient and public participation in health technology assessment and coverage decisions","volume":"11","author":"Menon","year":"2011","journal-title":"Expert Rev. Pharmacoecon Outcomes Res."},{"key":"B72","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1016\/j.jval.2020.06.003","article-title":"Are we making a difference? A qualitative study of patient engagement at the Pan-Canadian oncology drug review: perspectives of patient groups","volume":"23","author":"Mercer","year":"2020","journal-title":"Value Health"},{"key":"B73","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/BF03262492","article-title":"A pilot study to identify areas for further improvements in patient and public involvement in health technology assessments for medicines","volume":"5","author":"Messina","year":"2012","journal-title":"Patient"},{"key":"B74","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1017\/S0266462311000559","article-title":"An uneven spread: a review of public involvement in the national institute of health Research's health technology assessment program","volume":"27","author":"Moran","year":"2011","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B75","doi-asserted-by":"publisher","first-page":"e51","DOI":"10.1017\/S0266462323000417","article-title":"Patient and citizen participation at the organizational level in health technology assessment: an exploratory study in five jurisdictions","volume":"39","author":"Nabarette","year":"2023","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B76","doi-asserted-by":"publisher","first-page":"767","DOI":"10.3917\/spub.187.0767","article-title":"Involving patients in the evaluation of health technologies at the French national authority for health (HAS)","volume":"30","author":"Nabarette","year":"2018","journal-title":"Sante Publique"},{"key":"B78","doi-asserted-by":"publisher","first-page":"38","DOI":"10.3390\/jmahp13030038","article-title":"Patient involvement in health technology assessments: lessons for EU joint clinical assessments","volume":"13","author":"Pickaert","year":"2025","journal-title":"J. Mark. Access Health Policy"},{"key":"B79","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.1017\/S0266462320000707","article-title":"Patients, users, caregivers, and citizens' involvement in local health technology assessment unit in Quebec: a survey","volume":"37","author":"Poder","year":"2020","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B80","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/hex.12989","article-title":"Co-construction of health technology assessment recommendations with patients: an example with cardiac defibrillator replacement","volume":"23","author":"Pomey","year":"2020","journal-title":"Health Expect."},{"key":"B81","doi-asserted-by":"publisher","first-page":"e020452","DOI":"10.1136\/bmjopen-2017-020452","article-title":"Frequency of reporting on patient and public involvement (PPI) in research studies published in a general medical journal: a descriptive study","volume":"8","author":"Price","year":"2018","journal-title":"BMJ Open"},{"key":"B82","doi-asserted-by":"publisher","first-page":"1693886","DOI":"10.3389\/fpubh.2025.1693886","article-title":"A comparative analysis of patient participation in health technology assessment systems worldwide: trends and practices","volume":"13","author":"Puebla","year":"2025","journal-title":"Front. Public Health"},{"key":"B83","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12962-019-0188-1","article-title":"Understanding and using patient experiences as evidence in healthcare priority setting","volume":"17","author":"Rand","year":"2019","journal-title":"Cost. Eff. Resour. Alloc."},{"key":"B84","doi-asserted-by":"publisher","first-page":"e12","DOI":"10.1017\/S0266462320002202","article-title":"Strengthening patient outcome evidence in health technology assessment: a coproduction approach","volume":"37","author":"Rasburn","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B85","doi-asserted-by":"crossref","first-page":"5243","DOI":"10.1007\/978-94-007-0753-5_2337","article-title":"Purposive sampling","volume-title":"Encyclopedia of quality of life and well-being research","author":"Robinson","year":"2014"},{"key":"B86","doi-asserted-by":"publisher","first-page":"287","DOI":"10.2147\/CEOR.S82549","article-title":"Evolution of health technology assessment: best practices of the pan-Canadian oncology drug review","volume":"7","author":"Rocchi","year":"2015","journal-title":"Clin. Outcomes Res."},{"key":"B87","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40900-016-0052-9","article-title":"Patient advocate perspectives on involvement in HTA: an international snapshot","volume":"3","author":"Scott","year":"2017","journal-title":"Res. Involv Engagem."},{"key":"B88","doi-asserted-by":"publisher","first-page":"e8","DOI":"10.1017\/S0266462321000647","article-title":"A framework for action to improve patient and public involvement in health technology assessment","volume":"38","author":"Silva","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B89","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1017\/S0266462319000552","article-title":"Stories of patient involvement impact in health technology assessments: a discussion paper","volume":"35","author":"Single","year":"2019","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B90","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s40900-021-00327-5","article-title":"Patient advocacy group involvement in health technology assessments: an observational study","volume":"7","author":"Single","year":"2021","journal-title":"Res. Involv. Engagem."},{"key":"B91","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s40900-020-00214-5","article-title":"The impact of patient involvement in research: a case study of the planning, conduct and dissemination of a clinical, controlled trial","volume":"6","author":"Skovlund","year":"2020","journal-title":"Res. Involv. Engagem."},{"key":"B92","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.1017\/S026646232000224X","article-title":"Scottish health technologies group: enhancing patient engagement","volume":"37","author":"Stewart","year":"2021","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B93","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1017\/S0266462319000096","article-title":"Toward a strategy to involve patients in health technology assessment in Spain","volume":"35","author":"Toledo-Ch\u00e1varri","year":"2019","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B94","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.1017\/S0266462320001956","article-title":"Development of a decisional flowchart for meaningful patient involvement in health technology assessment","volume":"37","author":"Toledo-Ch\u00e1varri","year":"","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B95","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1017\/S0266462320000586","article-title":"Evaluation of patient involvement strategies in health technology assessment in Spain: the viewpoint of HTA researchers","volume":"37","author":"Toledo-Ch\u00e1varri","year":"","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B96","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1017\/S0266462324000229","article-title":"Experiences of patient organizations' involvement in medicine appraisal and reimbursement processes in Finland - a qualitative study","volume":"40","author":"Tran","year":"2024","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B97","volume-title":"A researcher\u2019s guide to patient and public involvement","author":"Turk","year":"2017"},{"key":"B98","article-title":"Patient and public involvement in the pricing and reimbursement procedure: a scoping literature review","author":"Vanneste","year":"2025","journal-title":"Open Sci. Framew."},{"key":"B99","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1017\/S0266462317000976","article-title":"Evaluation of patient and public involvement initiatives in health technology assessment: a survey of international agencies","volume":"33","author":"Weeks","year":"2017","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"B100","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40900-020-00248-9","article-title":"Patients and public are important stakeholders in health technology assessment but the level of involvement is low - a call to action","volume":"7","author":"Wale","year":"2021","journal-title":"Res. Involv Engagem."},{"key":"B101","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jval.2012.09.011","article-title":"An international survey of the public engagement practices of health technology assessment organizations","volume":"16","author":"Whitty","year":"2013","journal-title":"Value Health"},{"key":"B102","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1108\/JHOM-08-2015-0119","article-title":"What factors determine the choice of public engagement undertaken by health technology assessment decision-making organizations?","volume":"30","author":"Wortley","year":"2016","journal-title":"J. Health Organ Manag."},{"key":"B103","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s13023-017-0738-6","article-title":"Exploring patient and family involvement in the lifecycle of an orphan drug: a scoping review","volume":"12","author":"Young","year":"2017","journal-title":"Orphanet J. Rare Dis."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1791567\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:34:14Z","timestamp":1776749654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1791567\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":103,"alternative-id":["10.3389\/fphar.2026.1791567"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1791567","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"article-number":"1791567"}}