Considering Severity in Health Technology Assessment: Can We Do Better?

Area of Science:

• Health Economics
• Public Health Policy
• Decision Sciences

Background:

• Societal value for health gains often correlates with health state severity.
• Health technology assessment (HTA) bodies increasingly consider health severity.
• Current methods for incorporating severity in HTA may lack consistency and fairness.

Purpose of the Study:

• To advocate for a more explicit and quantitative approach to health severity in HTA.
• To identify limitations of current categorical approaches to severity.
• To propose a continuous framework for assessing health severity.

Main Methods:

• Review of existing practices in health technology assessment regarding health severity.
• Analysis of the conceptual and practical drawbacks of categorical severity adjustments.
• Discussion of the implications for equity and consistency in HTA.

Main Results:

• Societal preference for greater value on health gains from more severe health states is evident.
• Existing categorical approaches in HTA present discontinuities that may conflict with equity principles.
• A continuous approach offers potential for fairer and more consistent severity adjustments.

Conclusions:

• A more explicit, quantitative, and continuous approach to health severity is essential for equitable HTA.
• Transitioning from categorical to continuous severity assessment presents challenges but is necessary for fairness.
• Further research is needed to develop and implement continuous severity adjustment methods in HTA.