All societies face the need to make judgments about what interventions (both public health and personal medical) to provide to their populations under reasonable resource constraints. Their decisions should be informed by good evidence and arguments from health technology assessment (HTA). But if HTA restricts itself to evaluations of safety, efficacy, and cost-effectiveness, it risks being viewed as insufficient to guide health decision-makers; if it addresses other issues, such as budget impact, equity, and financial protection, it may be accused of overreaching. But the risk of overreaching can be reduced by embedding HTA in a fair, deliberative process that meets the conditions required by accountability for reasonableness.
Commentaries Published on this Paper
Beyond the Black Box Approach to Ethics!; Comment on “Expanded HTA: Enhancing Fairness and Legitimacy”
Daniels N. Just Health: Meeting Health Needs Fairly. Cambridge University Press; 2008.
Banta D. The development of health technology assessment. Health Policy. 2003;63(2):121-132.
Hoffman B. Toward a procedure for integrating moral issues in health technology assessment.Int J Technol Assess Health Care. 2005;21(3):312-318.
Hoffman B. Why not integrate ethics in HTA: identification and assessment of the reasons.GMS Health Technol Assess. 2014;10:Doc04. doi:10.3205/hta000120
Siegel JE, Weinstein MC, Russell LB, Gold MR. Recommendations for reporting cost-effectiveness analyses. JAMA. 1996;276(16):1339-1341. doi:10.1001/jama.1996.03540160061034
Daniels N, Sabin JE. Setting Limits Fairly: Learning to Share Resources for Health. Oxford University Press; 2008.
Norheim OF, Ottersen T, Voorhoeve A, et al. Making Fair Choices on the Path to Universal Health Coverage. Geneva: WHO; 2014.
Daniels N, Charvel S, Gelpi AH, Porteny T, Urrutia J. Role of the courts in the progressive realization of the right to health: between the threat and the promise of judicialization in Mexico. Health Systems & Reform. 2015;1:229-234. doi:10.1080/23288604.2014.1002705