Social Participation in CONITEC: Democratic Progress and a Challenge for Health Technology Assessment (HTA)

In May 2026, CONITEC confirmed the incorporation of two health technologies after issuing preliminary unfavorable recommendations: lenalidomide for multiple myeloma and the combination of venetoclax + azacitidine for acute myeloid leukemia. It may be tempting to attribute these reversals solely to public mobilization, but the official reports tell a more technical story.

For venetoclax + azacitidine, the preliminary unfavorable recommendation was primarily related to the need for a larger price discount and updated budget impact analyses, while the clinical evidence was already considered largely satisfactory. Following the public consultation, a new pricing proposal was submitted, adoption rate assumptions were revised, and economic impact estimates were reduced. The final decision considered the complete body of evidence: clinical data, public consultation contributions, and the revised commercial proposal.

For lenalidomide, the discussion involved the comparator (thalidomide and its adverse events), the clinical evidence, the healthcare context, supply conditions, and economic considerations, in addition to contributions from society. The public consultation was even reopened after a form error, highlighting the importance of maintaining a robust and transparent process.

In other words, social participation and methodological rigor are not opposing forces. Preliminary recommendations may change after public consultation because new clinical, economic, healthcare, and societal information becomes available. The challenge is not to choose between technical assessment and public participation, but to ensure transparent processes that appropriately weigh every type of evidence.

How does your organization assess the relative importance of different types of evidence in CONITEC's decisions?

Sources: CONITEC – Reports to Society No. 608 (venetoclax + azacitidine) and No. 598 (lenalidomide); SCTIE/MS Ordinance No. 26/2026 (incorporation of lenalidomide). Accessed July 2026.