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EU HTA PICO Framework for Medical Devices

Preparing for Joint Clinical Assessments with Early PICO Planning

MTRC provides Early PICO Planning services to support a smooth and effective Joint Clinical Assessment (JCA) process under the new EU Health Technology Assessment (HTA) Regulation for innovative medical devices.

With the enforcement of the EU HTA Regulation, medical device manufacturers face intensified requirements to demonstrate clinical value for market access, HTA endorsement, and reimbursement across the European Union. The Joint Clinical Assessment (JCA) will be a pivotal step in this process.

A key component of the JCA is scoping, which uses the PICO (Population, Intervention, Comparator, Outcomes) framework to define the specific parameters of an HTA review:

  • Population: The patient demographic or clinical setting for which the device is intended
  • Intervention: The medical device or procedure being evaluated
  • Comparator: The current standard of care or alternative solutions
  • Outcomes: Clinical, patient-centric, or economic measures assessing effectiveness and safety

One challenge of the JCA PICO process is that each EU member state can submit inputs, potentially leading to numerous final PICOs. This complexity means manufacturers must address all suggested populations, comparators, and outcomes in a very short time, reserved for development of the HTA application. Member-state-driven variability and tight timelines can be a major hurdle for successful preparation.

MTRC’s unique expertise in EU Med Tech market access, HTA, and PICO-driven planning helps you navigate these challenges with confidence, ensuring a stronger market position for your medical technologies.
 

Early PICO Planning Process

At MTRC, we guide you through each stage of HTA preparation with a focus on creating an optimized PICO framework for your medical device.

Analyze the Current Diagnostic and Treatment Landscape in All Member States

We analyze clinical guidelines by clinical societies and governmental organizations (e.g. HAS in France and National Board of Health and Welfare in Sweden), audits and patient registries as well as published surveys of physicians or medical chart reviews to understand current patient pathways in all member states.

Determine the Position of Reimbursement and HTA Authorities

We evaluate perspectives from reimbursement and HTA organizations by examining previously published HTA reports, reimbursement decisions, and other relevant documents. This helps us identify member-state-specific patient populations, preferred comparators (reflecting the standard of care), and outcomes, all of which may vary significantly by country.

Consolidate PICOs for All Member States

Utilizing analysis of current clinical practice, previous reimbursement and HTA decisions, we develop a comprehensive list of potential PICOs. This consolidated framework reflects variations in practice and payer expectations across EU member states.

Develop Strategic Recommendations for Evidence Generation

We conclude the process by providing a strategic gap analysis and recommending next steps for evidence generation, ensuring you are well-prepared for a successful JCA submission.

Why partner with MTRC?

Be confident in the results

We are accredited by the United Kingdom Accreditation Service (UKAS) as an ISO 9001:2015 certified vendor, specialised in medical technologies market access. Unlike many of our competitors, we dedicate 100% of our time and focus to the area of medical technologies, so that our clients enjoy higher quality services at a lower cost. We are also probably the largest Med Tech market access consultancy in Europe, which helps us accumulate unique knowledge and insights. MTRC is a proud member of ABHI, the UK’s leading industry association for health technology (HealthTech)

Leverage unique Pan-European expertise

MTRC covers 20 European countries, including Austria, Belgium, Czech Republic, Denmark, England, Finland, France, Germany, Hungary, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Romania, Spain, Sweden, and Switzerland. Our unparalleled breadth uniquely positions us to address the diverse requirements of multiple EU member states in the JCA preparation process.

Spend less on consulting

We understand the budgetary challenges of the med tech industry and can therefore offer a cost-effective approach to our specialised services. Twelve (12%) of our current business comes from small to medium-sized enterprises (SMEs) – a testament to our unique and personal approach to solve your budgetary challenges

Make decisions and advance your business quickly

We appreciate the time-sensitive nature of market access. Being a flexible team, we are not afraid to go beyond regular working hours to meet the high expectations of our clients. For every type of project, we offer the shortest possible turnaround times

News and insights

Another medical device preliminarily selected for EU Joint Clinical Assessment

On 28 October 2026, the European Commission published a draft implementing act proposing the selection of PRIMA Products for Joint Clinical Assessment (JCA) at the EU level under Regulation (EU) 2021/2282. A second technology, the CEVIRA device for cervical photodynamic therapy, was not selected for JCA. The draft will be discussed at the HTA Committee meeting on 13 November 2026 before the formal adoption process is completed.

EU HTA Publication Digest: From Joint Clinical Assessment to National Decisions: EU HTA Implementation and Implications for Patient Access

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its Health Economic Publications Digest. In a recent publication, D'Oca et al. explored early national perspectives on the implementation of Joint Clinical Assessments under the EU HTA Regulation.

EU HTA Publication Digest: The EU-Joint Clinical Assessment Guidance Documents Fail to Address the Significance of Systematic Literature Reviews and Deviate from the State of the Art

MTRC shares the most relevant and impactful publications in the field of market access and HEOR for medical technologies in Europe through its EU HTA Publications Digest. In a recent publication, Smela et al. analyzed recommendations for systematic literature reviews within the EU Joint Clinical Assessment framework and compared them with established evidence-based medicine standards.

European Coverage

MTRC routinely supports multi-country projects across 14 major European markets, helping clients compare reimbursement, payer, HTA, evidence and health economic requirements through one consistent specialist partner.

Core markets include Austria, Belgium, Denmark, England, Finland, France, Germany, Ireland, Italy, the Netherlands, Norway, Spain, Sweden and Switzerland.
 

 

MTRC in Numbers 

Specialist European MedTech Access Expertise at Scale

26
26
Full-time employees
1,072
1,072
Projects
240
240
Clients
19
19
Regular clients from the top 30 med tech companies
34%
34%
Of business comes from Small to Medium-sized Enterprises (SMEs)

Get in touch

Contact us to discuss your needs and learn about our services