Table 2.

List of different Stakeholder groups increasingly involved in the appraisal stage of HTA with dedicated contribution, special needs (to understand and capture a drug's mechanism, effect, role, or impact) and example of how mechanistic modeling can help to address this need and fill persistent gaps.

Stakeholder group	Contribution to HTA	Needs	Role of mechanistic models for increasing stakeholder involvement
Individual patients or disease-specific citizen and/or patient organizations/associations or caregiver and family member groups	First-hand experiential knowledge of living with a particular health condition; experience with the health technology under assessment, or currently available technologies, the use of associated health services, and associated benefits, risks, and side effects	Needs to understand the impact of a new MP on personal and individual health status, personal risks, and benefits	Establish plausibility and interactivity of clinical decision-making Highlight potential individual consequences from clinical decision making Highlight individual patient contribution to outcomes (e.g., compliance)
Citizen and health system user organizations not specific to any condition or disease. Public in general	May lack knowledge about disease or health technology in question but can assess transparency, legitimacy, and fairness in decision making (61)	Needs to understand reasoning in the decision-making process	Establish plausibility and interactivity of the policy decision-making
Healthcare professionals Organizations of healthcare professionals	Gather expertise on clinical aspects regarding: the disease/condition; medical needs; available therapies; the technology under assessment	Needs to be convinced about the new health technology being the best therapeutic approach to be delivered to a patient.	Provide clinically relevant scenarios of HT impact on outcomes, among other comparator approaches
	Identify clinically relevant patient population (and/or subgroups), comparators, thresholds for improvement	Needs to decide, diagnose, or prescribe based on large and complex scientific knowledge	Provide a comprehensive view of all the available scientific knowledge
	Gather information on clinically relevant outcomes including possible neglected outcomes
	Gaining further information on the importance of outcomes from a healthcare professional point of view (62)
Policymakers	Can judge the expected benefit for healthcare on a national or regional level given the specific political background (63)	Need to estimate a new treatment impact on a national or regional level	Provide trustworthy estimation of a new treatment benefit on a specific population where little data is available
Payers	Contribute expertise on reimbursement/coverage decisions Can highlight specific national or regional economic background	Need to estimate a new treatment impact on a national or regional level	Provide trustworthy estimation of a new treatment benefit on a specific population where little data is available
Companies and associations producing health technologies	Technology manufacturers can take part (as peers) in all discussions and meetings about contributed data to clarify concerns and provide additional information to support coverage of their products (64).	Needs to understand and rationalize questions and concerns vs. specific available data	Show how technology manufacturer's data fits into the overall evidence Highlight technology and product specific properties with respect to reference
Academics	Provide cross-disciplinary scientific feedback from public health, economics, ethics, and social sciences	Needs to understand the bigger picture of HT	Provide information for other models and assessments