Equity in national healthcare economic evaluation guidelines: Essential or extraneous?

Front page of Social Science & Medicine

13 Aug 2024

Avşar et al.

The study included 46 guidelines from 51 countries. Only 30% of the guidelines were explicit about the equity assumptions. Health equity (using a broad definition) was mentioned in 29 guidelines and 14 included a specific definition while only seven recommended specific methods to incorporate inequalities. Addressing equity concerns was usually suggested as an additional analyses rather than a key part of the assessment. It was unclear how equity was incorporated into decision-making processes. In addition, equity was mentioned in other guidance – such as decision-making frameworks – provided by five agencies that did not mention it in the HEE guidelines, and 7 of 14 topic selection criteria that were identified.

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Key issues

HEALTH SERVICES AND SYSTEMS

Covering developments in the provision, funding and organisation of health care services.

EQUITY

Exploring the impacts of the health system on minorities within the population, notably including Māori, Pacifica, Asians and LGBTQI.

DRUGS, DEVICE AND DIAGNOSTICS

Covering prescription medicines and medical devices.

PUBLIC HEALTH

Focusing on efforts to promote health and prevent disease through social and economic interventions.

DIGITAL HEALTH

Exploring the potential digital transformation to provide a more connected and accessible health system.

TE TIRITI

Monitoring how the health reforms and the performance of the health sector uphold Te Tiriti obligations.