title: Expanded HTA: Enhancing Fairness and Legitimacy.
abstract: 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.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Daniels
authors.affiliation: Interfaculty Initiative in Health Policy, Harvard University, Cambridge, MA, USA.
authors.forename: Thalia
authors.initials: T
authors.lastname: Porteny
authors.affiliation: Interfaculty Initiative in Health Policy, Harvard University, Cambridge, MA, USA.
authors.forename: Julian
authors.initials: J
authors.lastname: Urritia
mesh_terms: D003659:Decision Making, Organizational; D003695:Delivery of Health Care / Q000458:organization & administration*; D015276:Health Care Rationing / Q000379:methods*; D006801:Humans; D012941:Social Responsibility; D013673:Technology Assessment, Biomedical / Q000379:methods*
keywords: Accountability for Reasonableness; Budget Impact; Cost-effectiveness; Efficacy; Equity; Fairness; Financial Protection; Health Technology Assessment (HTA); Legitimacy; Safety