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An Equity Framework for Health Technology Assessments

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  • Anthony J. Culyer
  • Yvonne Bombard

Abstract

Despite the inclusion of equity in the design of many health care systems, pragmatic tools for considering equity systematically, alongside the efficiency categories of cost-effectiveness in health technology assessment (HTA), remain underdeveloped. This article develops a framework to help decision makers supplement the standard efficiency criteria of HTA and avoid building inequities, explicit or implicit, into their methods. The framework is intended as a first step toward creating a checklist for alerting decision makers to a wide range of equity considerations for HTA. This framework is intended be used as part of the process through which advisory bodies receive their terms of reference; scope the agenda prior to the selection of a candidate intervention and its comparators for HTA; prepare background briefing for decision makers; and help to structure the discussion and composition of professional and lay advisory groups during the assessment process. The framework is offered as only a beginning of an ongoing process of deliberation and consultation, through which the matters covered can be expected to become more comprehensive and the record of past decisions and their contexts in any jurisdiction adopting the tool can serve to guide subsequent evidence gathering and decisions. In these ways, it may be hoped that equity will be more systematically and fully considered and implemented in both the procedures and decisions of HTA.

Suggested Citation

  • Anthony J. Culyer & Yvonne Bombard, 2012. "An Equity Framework for Health Technology Assessments," Medical Decision Making, , vol. 32(3), pages 428-441, May.
  • Handle: RePEc:sae:medema:v:32:y:2012:i:3:p:428-441
    DOI: 10.1177/0272989X11426484
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    2. Stéphane Verguet & Ramanan Laxminarayan & Dean T. Jamison, 2015. "Universal Public Finance of Tuberculosis Treatment in India: An Extended Cost‐Effectiveness Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 318-332, March.
    3. Tuba Saygın Avşar & Xiaozhe Yang & Paula Lorgelly, 2023. "How is the Societal Perspective Defined in Health Technology Assessment? Guidelines from Around the Globe," PharmacoEconomics, Springer, vol. 41(2), pages 123-138, February.
    4. Denburg, Avram E. & Ungar, Wendy J. & Chen, Shiyi & Hurley, Jeremiah & Abelson, Julia, 2020. "Does moral reasoning influence public values for health care priority setting?: A population-based randomized stated preference survey," Health Policy, Elsevier, vol. 124(6), pages 647-658.

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