At HTAi 2026 in Istanbul, one message came through clearly: delivering high-quality health technology assessment (HTA) is no longer the end goal. It is the starting point. The real challenge is ensuring that evidence leads to sustainable policy, effective implementation, and measurable impact for patients.

Sven Tops, Chief Market Access Officer, Ruth Howells, Country Manager for the UK and Ireland, and Julia Sus, Director of Market Access, represented Kintiga at the conference. The themes emerging from Istanbul closely align with the challenges Kintiga is helping clients navigate today, particularly the need for earlier strategic alignment, stronger integration across functions, and a sharper focus on implementation in diverse market contexts.

Across plenary sessions, panels, and case studies, a consistent narrative emerged. Under the theme “HTA as a System Shaper,” the conference positioned HTA not just as a technical evaluation tool, but as a strategic process that can influence governance, equity, and system resilience. At the same time, there was a clear recognition that progress on implementation is uneven. The question is no longer what HTA could do, but whether systems and organisations are evolving quickly enough to deliver on that potential.

Designing HTA Systems for Real-World Impact

The closing plenary, “The How of HTA: Methods, Tools & Capacity for System Shaping,” offered a practical view of what comes next. It encouraged a shift in perspective. HTA should not be seen as a static report, but as part of a wider system that needs to drive real-world change. Several priorities emerged:

• Sustainability and resilience need to be built into HTA systems from the outset so they can adapt to political, economic, and technological pressures.
• Value frameworks are also expanding, with environmental sustainability beginning to sit alongside clinical and economic outcomes, although methods are still in development.
• Capacity building must extend beyond analysts to include policymakers and implementers who make decisions based on HTA.
• Local context is equally important, particularly in low- and middle-income settings, where applying standardised approaches can reduce relevance.

The message was straightforward: HTA will only deliver value if it is part of a system that is designed to act on it. Organisations that treat HTA as a system-level challenge, rather than a submission exercise, will be best positioned to secure access and deliver impact.

AI in HTA: From Promise to Responsible Adoption

Artificial intelligence was a major theme at HTAi 2026, but the discussion has clearly matured. The focus is no longer on whether AI will transform HTA, but on how to make that transformation trustworthy, transparent, and equitable.

Recent work from the HTAi Global Policy Forum highlights the importance of trust, human oversight, and managing bias. At the same time, it is important to stay grounded in where the field actually is today. Evidence suggests that AI is still used in only a limited way in HTA submissions, with most organisations still in pilot or early exploration stages.

This creates a clear tension. The potential is significant, but success will depend less on the technology itself and more on governance, validation, and organisational readiness. Efforts to develop digital HTA frameworks and evaluate AI-enabled technologies show that progress is happening, but it is gradual and pragmatic.

The takeaway is simple: AI is likely to shape the future of HTA, but only if it is implemented in a way that builds trust and delivers real value.

EU Joint Clinical Assessment: Strategy Meets Reality

The European Joint Clinical Assessment (JCA) is an important development in HTA, and early experience shows both its potential and its challenges.

Comparator selection and early alignment on PICOs will be a key consideration within the JCA process. Evidence from recent work shows just how complex this can be, with multiple PICOs often required and increasing reliance on indirect comparisons.

Taken together, this points to a system that is strategically well defined, but still maturing operationally. For industry, it reinforces the need to plan early and build evidence strategies that are aligned from the outset.

Redefining Value in HTA

Another important theme from HTAi 2026 was the evolving definition of value. HTA is increasingly moving beyond a narrow focus on clinical and economic outcomes.

There is growing attention on broader societal impact, including productivity and quality of life, as well as greater emphasis on patient-centred outcomes and day-to-day functioning. There is also increasing interest in how health systems adapt to change, which is becoming an important dimension of value.

Environmental sustainability is starting to enter the discussion, but it is still at an early stage and not yet consistently integrated into decision-making. At the same time, ongoing discussions about disease burden and access highlight the importance of context. Value cannot be defined in the same way everywhere. It needs to reflect local realities.

From Innovation to Implementation: The Real Bottleneck

Across all of these themes, one issue came up repeatedly. The biggest challenge in HTA today is not innovation. It is implementation.

Barriers are well known. Frameworks are fragmented, best practices are still emerging, and real-world impact is not always measured consistently. There are also gaps in skills, governance, and organisational readiness. This helps explain why adoption remains uneven, even when new methods and tools are available.

The path forward is not about running more pilots. It is about building systems that can scale what already works.

A Practical Agenda for the Next Phase

Turning ambition into action will require focus in a few key areas:

• Build adaptability into HTA systems, moving towards lifecycle-based approaches
• Invest in capacity across the whole ecosystem, not just within analytical teams
• Strengthen trust in AI through governance, validation, and transparency
• Align evidence generation early, especially comparator strategies and PICOs
• Take a structured approach to adopting new methods, recognising different levels of maturity

What’s next for HTA?

Health systems are under pressure from rising costs, rapid technological change, and increasing complexity. At the same time, expectations of HTA continue to grow.

Three shifts stand out.

• Value is becoming broader and more multi-dimensional
• Data and digital innovation are reshaping how evidence is generated and used, although progress is uneven
• HTA itself is attempting to evolve into something more dynamic and system-focused

The question is no longer whether this transformation should happen. The real question is how quickly we can align evidence, policy, and implementation to make it work in practice, and at scale.

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