Transportability of nonlocal real-world evidence and its relevance to health technology assessment: a primer

Real-world evidence (RWE) from outside Canada or the UK is sometimes included in submissions to health technology assessments by Canada’s Drug Agency/L'Agence des médicaments du Canada (CDA-AMC) and National Institute for Health and Care Excellence when local data are lacking, particularly in rare diseases. However, differences in population demographics, healthcare systems and clinical practice patterns between different jurisdictions can pose challenges for contextualizing nonlocal data for health technology assessments. This primer outlines the challenges of using nonlocal RWE for decision-making, presents assumptions necessary for transportability of RWE, and describes quantitative methods to address these challenges. This primer is written for a broad audience, including industry stakeholders, researchers and clinicians, who are seeking accessible guidance on the use of nonlocal RWE and developments in the field of transportability.