An equity framework for health technology assessments.

TitleAn equity framework for health technology assessments.
Publication TypeJournal Article
Year of Publication2012
AuthorsCulyer AJ, Bombard Y
JournalMedical decision making : an international journal of the Society for Medical Decision Making
Volume32
Issue3
Pagination428-41
Date Published2012 May-Jun
ISSN1552-681X
KeywordsBias (Epidemiology); Biomedical Technology; Casuistry; Checklist; Cost-benefit analysis; Decision Making; Delivery of health Care; Health Status Disparities; Humans; Models, Organizational; Ontario; Social Justice; Technology Assessment, Biomedical
AbstractDespite the inclusion of equity in the design of many health care systems, pragmatic tools for considering equity systematically, alongside the efficiency categories of cost-effectiveness in health technology assessment (HTA), remain underdeveloped. This article develops a framework to help decision makers supplement the standard efficiency criteria of HTA and avoid building inequities, explicit or implicit, into their methods. The framework is intended as a first step toward creating a checklist for alerting decision makers to a wide range of equity considerations for HTA. This framework is intended be used as part of the process through which advisory bodies receive their terms of reference; scope the agenda prior to the selection of a candidate intervention and its comparators for HTA; prepare background briefing for decision makers; and help to structure the discussion and composition of professional and lay advisory groups during the assessment process. The framework is offered as only a beginning of an ongoing process of deliberation and consultation, through which the matters covered can be expected to become more comprehensive and the record of past decisions and their contexts in any jurisdiction adopting the tool can serve to guide subsequent evidence gathering and decisions. In these ways, it may be hoped that equity will be more systematically and fully considered and implemented in both the procedures and decisions of HTA.
DOI10.1177/0272989X11426484
Alternate JournalMed Decis Making