This document introduces an academic article titled “Identification of health-related needs: The needs examination, evaluation and dissemination (NEED) assessment framework“. Authored by Charline Maertens de Noordhout, Muriel Levy, Rani Claerman, Mats de Jaeger, Robby De Pauw, Laurence Kohn, Claudia Schönborn, and Irina Cleemput, the article was published in Health policy 155 (2025) 105263 and became available online on February 13, 2025. The work originates from the KCE, Belgian Health Care Knowledge Centre, and Sciensano.
The article addresses a critical issue in current healthcare: innovation is largely supply-driven, which results in underinvestment in less profitable health areas, the persistence of unmet needs, and inefficient use of public resources. Pharmaceutical research and development (R&D), for instance, often prioritizes profitability over addressing urgent health concerns, leading to limited investment in areas of greatest need. Furthermore, existing regulatory processes tend to focus on evaluating individual technologies rather than considering broader societal health needs, contributing to inefficiencies and inequities in resource allocation. While European and national initiatives aim to support the development of medicines for unmet medical needs, the concept itself has lacked a clear and consistent definition across stakeholders.
To bridge this gap, the study proposes the Needs Examination, Evaluation and Dissemination (NEED) assessment framework. This framework is designed to structure the identification of health-related patient and societal needs across various health conditions. It represents an important first step towards a more needs-driven healthcare policy and innovation landscape. Previously, a comprehensive framework specifically for identifying disease-specific unmet needs was lacking.
The development of the NEED framework was rigorous, based on:
- The results of two systematic literature reviews: one focusing on patient needs criteria and the other on societal needs criteria.
- Stakeholder and expert consultation, which helped refine criteria and incorporate crucial perspectives.
The NEED framework integrates three core dimensions to evaluate health-related needs:
- Patient Needs: These stem from the direct impact of a health condition on patients’ lives and well-being. Patient needs cover aspects like impact on quality of life, physical and psychological health, autonomy, life expectancy, treatment effectiveness and burden, quality of care, accessibility of healthcare, and social impacts such as social support, education, work, and financial consequences.
- Societal Needs: These encompass the broader impact of health conditions on society, including negative externalities and collective needs that extend beyond individual patient needs. Societal needs include criteria like frequency and transmissibility of the condition, antimicrobial resistance (AMR), burden on informal caregivers, value for money of standard of care, preventability, productivity losses, and environmental impact of standard of care.
- Future Needs: This dimension anticipates the long-term health and economic burdens that future generations might face due to a health condition. It includes criteria for future burden of disease (e.g., prevalence, years of life lost, years lived with disability) and future economic burden (e.g., direct and indirect costs).
Across these dimensions, the framework categorizes needs into three key domains:
- Health needs: Focus on the burden of the disease and the need for better health (e.g., pain, suffering, quality of life).
- Healthcare needs: Pertain to the need for healthcare services, including treatments, preventive measures, and nursing services.
- Social needs: Relate to aspects of the socio-economic environment, such as social support, work, or the environmental footprint of healthcare.
Equity is recognized as a transverse dimension within the framework. This means that data on unmet needs should be disaggregated by population subgroups (e.g., age, gender, socioeconomic status) to identify disparities and ensure fairness.
The NEED framework ultimately comprises 23 criteria and 43 measurable indicators to assess the extent to which needs are met or unmet. Data for these indicators can be collected using a mixed-method approach, combining primary data collection (e.g., patient surveys, interviews, expert opinions) and secondary data collection (e.g., literature reviews, existing databases).
The framework is a valuable tool for various actors in the health sector, including:
- Health(care) system decision-makers for priority-setting processes.
- R&D funding organizations to evaluate research proposals and allocate funding effectively.
- Pricing and Reimbursement (P&R) agencies, national/multi-national Health Technology Assessment (HTA) agencies, and medicines agencies to evaluate unmet needs for decision-making.
- Policymakers, researchers, patient representatives, and industry.
By providing a structured and comprehensive approach to evaluating health-related needs from patient, societal, and future perspectives, the NEED framework offers valuable insights for informing healthcare policies, with the ultimate goal of improving population health and well-being.
Reference: Maertens de Noordhout, C., Levy, M., Claerman, R., de Jaeger, M., De Pauw, R., Kohn, L., Schönborn, C., & Cleemput, I. (2025). Identification of health-related needs: The needs examination, evaluation and dissemination (NEED) assessment framework. Health policy, 155, 105263. https://doi.org/10.1016/j.healthpol.2025.105263