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      Evidence-Informed Deliberative Processes for HTA Around the Globe: Exploring the Next Frontiers of HTA and Best Practices Comment on "Use of Evidence-informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe"

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          Abstract

          This comment reflects on an article by Oortwijn, Jansen, and Baltussen about the use and features of ‘evidence-informed deliberative processes’ (EDPs) among health technology assessment (HTA) agencies around the world and the need for more guidance. First, we highlight procedural aspects that are relevant across key steps of EDP, focusing on conflict of interest, the different roles of stakeholders throughout a HTA and public justification of decisions. Second, we discuss new knowledge and models needed to maximize the value of deliberative processes at the expanding frontiers of HTA, paying special attention to when HTA is applied in primary care, employed for public health interventions, and is produced through international collaboration.

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          Accountability for reasonableness

          N Daniels (2000)
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            Health Technology Assessment capacity development in low- and middle-income countries: Experiences from the international units of HITAP and NICE

            Sripen Tantivess, Kalipso Chalkidou, Nattha Tritasavit … (2017)
            Health Technology Assessment (HTA) is policy research that aims to inform priority setting and resource allocation. HTA is increasingly recognized as a useful policy tool in low- and middle-income countries (LMICs), where there is a substantial need for evidence to guide Universal Health Coverage policies, such as benefit coverage, quality improvement interventions and quality standards, all of which aim at improving the efficiency and equity of the healthcare system. The Health Intervention and Technology Assessment Program (HITAP), Thailand, and the National Institute for Health and Care Excellence (NICE), UK, are national HTA organizations providing technical support to governments in LMICs to build up their priority setting capacity. This paper draws lessons from their capacity building programs in India, Colombia, Myanmar, the Philippines, and Vietnam. Such experiences suggest that it is not only technical capacity, for example analytical techniques for conducting economic evaluation, but also management, coordination and communication capacity that support the generation and use of HTA evidence in the respective settings. The learned lessons may help guide the development of HTA capacity in other LMICs.
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              Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services

              Ole Norheim (2016)
              Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population’s health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Health Policy Manag
                Journal ID (publisher-id): Int J Health Policy Manag
                Journal ID (pmc): ijhpm
                Journal ID (publisher-id): Kerman University of Medical Sciences
                Title: International Journal of Health Policy and Management
                Publisher: Kerman University of Medical Sciences
                ISSN (Electronic): 2322-5939
                Publication date Collection: April 2021
                Publication date (Electronic): 05 August 2020
                Volume: 10
                Issue: 4
                Pages: 232-236
                Affiliations
                1Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.
                2Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
                3Global Health Development Group, Imperial College London School of Public Health, London, UK.
                4Center for Global Development Europe, London, UK.
                Author notes
                [* ]Correspondence to: Unni Gopinathan Email: unni.gnathan@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-7145-1461
                https://orcid.org/0000-0002-7087-2803
                Article
                DOI: 10.34172/ijhpm.2020.145
                PMC ID: 8167266
                PubMed ID: 32772012
                SO-VID: 48e057dc-559b-448f-8555-8275994bc13e
                Copyright © © 2021 The Author(s); Published by Kerman University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 May 2020
                Date accepted : 21 July 2020
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                References: 35
                Categories
                Subject: Commentary

                Keywords: health technology assessment,health policy,deliberative processes,decision-making,priority setting
                Data availability:
                Keywords: health technology assessment, health policy, deliberative processes, decision-making, priority setting

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