Evidence-Informed Deliberative Processes for Health Benefit Package Design - Part II: A Practical Guide

Area of Science:

• Health Technology Assessment (HTA)
• Evidence-Informed Deliberative Processes (EDPs)

Background:

• HTA is crucial for global health benefit package design.
• EDPs enhance package design through stakeholder deliberation and evidence-informed values.
• This paper details practical guidance for EDPs, complementing a conceptual framework.

Approach:

• The 2019 EDP guide was updated using global expert surveys (66 experts, 27 HTA bodies) and country implementations.
• Revised EDP steps are presented, analyzing legitimacy practices in HTA bodies across Australia, Brazil, Canada, France, Germany, Scotland, Thailand, and the UK.
• Literature review via PubMed and HTA websites informed the analysis.

Key Points:

• Global HTA bodies exhibit significant variation in addressing legitimacy (stakeholder involvement, evidence evaluation, transparency, appeal).
• Despite increased focus on decision-making legitimacy, many HTA bodies are nascent in developing relevant activities.
• Recommendations are provided for HTA bodies to enhance legitimacy in their processes.

Conclusions:

• The design and implementation of EDPs are in early stages.
• A call for systematic analysis of international experiences to infer general EDP principles is made.