International Journal of Health Policy and Management

International Journal of Health Policy and Management

FairChoices: A Decision Support Toolkit for Making Evidence-Informed, Equity-Sensitive Choices on the Path to UHC; Comment on “Selecting Cost-Effectiveness Methods for Health Benefits Package Design: A Systematic Approach”

Articles in Press

Document Type : Commentary

Authors
Kjell Arne Johansson 1
Øystein Ariansen Haaland 1
Prasanna Tuladhar 1
Sali Ahmed 1
Krishna Kumar Aryal 1
Tarun Shankar Choudhary 1
David A. Watkins 2, 3
1 Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
2 Department of Global Health, University of Washington, Seattle, WA, USA
3 Division of General Internal Medicine, University of Washington, Seattle, WA, USA
Abstract
National governments face difficult choices about which interventions to prioritize within their health benefits packages. A recent approach called adaptive health technology assessment (aHTA) seeks to address gaps in economic evidence for priority-setting. In this commentary, we reflect on how conventional HTA is imperfectly suited to health benefits package reform processes. We present the rationale and design of a decision support toolkit called “FairChoices,” which builds on the principles of adaptive HTA. Compared with other decision-support approaches, FairChoices adds value by facilitating locally contextualized comparative cost-effectiveness analyses of interventions across the entire health sector using an integrated set of disease models and input data and standardized analytical assumptions, with equity metrics presented alongside cost-effectiveness. FairChoices is being developed in partnership with teams in Ethiopia, Zanzibar, Nepal, Ghana, and mainland Tanzania. The tool will eventually be released as a global public good to support priority-setting for universal health coverage (UHC) worldwide.

Keywords
Priority-Setting
Health Technology Assessment
Health Benefits Package
Decision Analysis
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International Journal of Health Policy and Management

Articles in Press, Accepted Manuscript
Available Online from 11 November 2026

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  • Received Date 10 September 2026
  • Revised Date 20 October 2026
  • Accepted Date 21 October 2026
  • First Published Date 11 November 2026
  • Published Date 11 November 2026