Brazilian Expert Consensus on the Use of Equity and Acceptability in Health Technology Assessment: A Delphi Panel

To achieve consensus among Brazilian experts on the concepts of equity and acceptability within the context of health technology assessment (HTA) in Brazil and to identify guidance for their practical application across assessment stages, operationalization methods, and strategies for evidence generation and use.

A 2-round online Delphi panel with Brazilian HTA experts assessed agreement on predefined literature-based concepts of equity and acceptability and explored perspectives on HTA stages, methods, and evidence generation and retrieval strategies. Reasons for disagreement and recommendations for further incorporating these dimensions were also qualitatively analyzed.

Participants were experienced HTA professionals, and consensus on the concepts of equity and acceptability was reached in the first round, exceeding the predefined threshold of 80% agreement. These dimensions were considered cross-cutting throughout the HTA process, with priority given to technology assessment, clinical guideline development, and implementation stages. Evidence search methods and cost-effectiveness analyses were prioritized for equity, whereas qualitative evidence and mixed methods were prioritized for acceptability. Strategies including secondary data analysis, primary data collection, and standardized filter use were prioritized for both dimensions.

This study advances the conceptual understanding of equity and acceptability in HTA and provides methodological guidance across process stages, supporting the development of more comprehensive HTA that is sensitive to inequities and responsive to population needs.