Key Strategies Released for Integrating Equity Into Health Technology Assessment

Today, the Center for Innovation & Value Research (the Center) released a new report highlighting actions for stakeholders to ensure health disparities and equity are being addressed in health technology assessment (HTA).¹

HTA is a systematic process used to evaluate the clinical and economic value of health care interventions. | Image credit: C Davids/peopleimages.com - stock.adobe.com

The report is the third and final report of a series with a focus on researching the benefits, risks, and costs of specific health care interventions. Evidence on these interventions is then weighed alongside other considerations to make informed decisions.²

"Our goal is to fundamentally transform the landscape of health technology assessment to reflect the diverse needs of patients better and ensure equity is at the forefront of every decision," said Jason Spangler, CEO of the Center, in a statement.¹ "By addressing the key domains of Power, People, and Processes; Data & Inputs and Methods; and Communications and Use, we aim to create a more inclusive and equitable health care system."

HTA is a systematic process used to evaluate the clinical and economic value of health care interventions.² It helps decision-makers, such as health plans, employers, and patients, by organizing and analyzing evidence on the accessibility, affordability, and delivery of these interventions. Additionally, HTA assesses factors like cost, safety, and efficacy to guide decisions on which treatments should be available and at what price.

While HTA is widely used in regions like the United Kingdom, the European Union, and Canada, its application in the United States has been more limited. Importantly, traditional HTA methods often overlook the fair distribution of resources, an essential component of health equity. As recent policy changes such as the Medicare Drug Price Negotiation Program expand HTA's role in value-based care, integrating an equity-centered approach is crucial to ensure that all patients benefit fairly from health care advancements.

In this report, the Center identified 4 foundational changes to communicate HTA research to patients and stakeholders:

Transparent Communication

Open communication is crucial for holding decision-makers accountable, particularly when their choices directly affect patients and caregivers. The report highlights the importance of 2-way communication throughout the HTA process.

Beyond academic publications, HTA practitioners are encouraged to use various formats, such as videos, infographics, and plain language summaries, to share findings in ways that are relevant and accessible to the people impacted by HTA decisions.

Understandable and Usable Information

Ensuring that HTA findings are communicated in a manner that is easy to understand also means considering the accessibility needs of diverse audiences, including people with disabilities. This might involve providing information in multiple formats, such as audio, video, or text, and ensuring that these formats are accessible to those with visual or hearing impairments.

The report also highlights the importance of offering translations and using culturally relevant examples and images to make the content more meaningful and relatable to different audiences. Ultimately, the goal is to ensure that HTA findings are not only clear but also actionable, enabling all stakeholders to make informed decisions based on the evidence presented.

Impacts on Different Groups of Patients

HTA practitioners must acknowledge uncertainties and limitations in HTA data and methods, such as biases. This includes discussing how the lack of subgroup analyses can obscure significant differences in how an intervention impacts various populations.

Discussions of health disparities should be grounded in an understanding of the root causes of inequities, such as systematic oppression, racism, and social disadvantage, rather than attributing poor health outcomes solely to factors like race, ethnicity, or gender identity.

A Holistic and Inclusive Approach

To advance equity in health care, HTA must evolve to incorporate mixed approaches that consider both cost-effectiveness and the factors that matter most to patients and caregivers, particularly those from underserved communities.

By broadening the criteria used in HTA to include equity considerations and integrating these assessments into a holistic, inclusive decision-making process, health care leaders can create policies and interventions that are not only effective and efficient but also fair and responsive to the diverse needs of all patients, particularly those in communities with persistent health inequities.

“By making these changes, HTA can better serve all patient populations, ensuring equitable access to innovative treatments and improving overall health care outcomes,” stated the report.

References

1. The Center’s health equity program releases final report in series highlighting action steps for integrating equity into HTA. Center for Innovation & Value Research. News release. September 4, 2024. Accessed September 4, 2024. https://valueresearch.org/press-release-the-centers-health-equity-program-releases-final-report-in-series-highlighting-action-steps-for-integrating-equity-into-hta/

2. Ridley M, Schultz E, Patel U, et al. Fulfilling the Promise of Equity in Value-Based Care: A Focus on Communications and Use in Health Technology Assessment. Center for Innovation & Value Research; August 2024. Accessed September 4, 2024. https://valueresearch.org/wp-content/uploads/2024/08/HEI-Comms-and-Use-Report_FINAL.pdf