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Fair Processes for Priority Setting: Putting Theory into Practice Comment on "Expanded HTA: Enhancing Fairness and
Maarten P Jansen1, Jan-Kees Helderman2, Bert Boer3
1Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
International Journal of Health Policy and Management
|December 23, 2016
Summary
This study proposes practical methods for integrating societal values into health technology assessment (HTA) through fair, evidence-informed deliberative processes, moving beyond theoretical frameworks for better reimbursement decisions.
Area of Science:
- Health Policy
- Health Economics
- Medical Ethics
Background:
- Current health technology assessment (HTA) practices often separate evidence appraisal from societal values.
- This separation hinders fair public reimbursement decisions for health technologies.
- Existing HTA frameworks for priority setting remain largely theoretical.
Purpose of the Study:
- To provide practical guidance for implementing fair processes in HTA.
- To address the misconception of fact-value relations in HTA.
- To advocate for an evidence-informed deliberative approach in HTA.
Main Methods:
- Critically analyze the fact-value dichotomy in HTA.
- Propose an HTA model centered on continuous learning and stakeholder deliberation.
- Examine implications for value inclusion, stakeholder engagement, and decision communication.
Main Results:
- Identified a fundamental misconception regarding facts and values in HTA.
- Proposed a shift from a linear assessment-appraisal split to an integrated deliberative process.
- Highlighted the need to consider diverse values and manage vested interests explicitly.
Conclusions:
- HTA should be reconceptualized as an ongoing, evidence-informed deliberative process.
- This approach facilitates learning and better incorporates societal values into reimbursement decisions.
- Implementing fair HTA processes requires a fundamental shift in current practices.
