Fair Processes for Priority Setting: Putting Theory into Practice Comment on "Expanded HTA: Enhancing Fairness and Legitimacy".

Maarten P Jansen,Rob Baltussen,Jan-Kees Helderman,Bert Boer

doi:10.15171/ijhpm.2016.85

Abstract

Embedding health technology assessment (HTA) in a fair process has great potential to capture societal values relevant to public reimbursement decisions on health technologies. However, the development of such processes for priority setting has largely been theoretical. In this paper, we provide further practical lead ways on how these processes can be implemented. We first present the misconception about the relation between facts and values that is since long misleading the conduct of HTA and underlies the current assessment-appraisal split. We then argue that HTA should instead be explicitly organized as an ongoing evidence-informed deliberative process, that facilitates learning among stakeholders. This has important consequences for whose values to consider, how to deal with vested interests, how to consider all values in the decision-making process, and how to communicate decisions. This is in stark contrast to how HTA processes are implemented now. It is time to set the stage for HTA as learning.

Highlights

Article History: Embedding health technology assessment (HTA) in a fair process has great potential to capture societal
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A demonstration of the misconception about the relation between facts and values is the prominent use of costeffectiveness analysis (CEA) as a method of evaluation in HTA

Summary

Introduction

Article History: Embedding health technology assessment (HTA) in a fair process has great potential to capture societal. Organizing Health Technology Assessment as a Learning Process Organizing ‘HTA as learning’[4,10,11,12,13] instead requires that well-organized deliberative processes and procedures are established that induce and help stakeholders spell-out what they find relevant values at the very start of the decisionmaking process.

Results

Conclusion