title: Fair Processes for Priority Setting: Putting Theory into Practice Comment on "Expanded HTA: Enhancing Fairness and Legitimacy".
abstract: Embedding health technology assessment (HTA) in a fair process has great potential to capture societal values relevant to public reimbursement decisions on health technologies. However, the development of such processes for priority setting has largely been theoretical. In this paper, we provide further practical lead ways on how these processes can be implemented. We first present the misconception about the relation between facts and values that is since long misleading the conduct of HTA and underlies the current assessment-appraisal split. We then argue that HTA should instead be explicitly organized as an ongoing evidence-informed deliberative process, that facilitates learning among stakeholders. This has important consequences for whose values to consider, how to deal with vested interests, how to consider all values in the decision-making process, and how to communicate decisions. This is in stark contrast to how HTA processes are implemented now. It is time to set the stage for HTA as learning.
authors.affiliation: Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Jansen
authors.affiliation: Institute for Management Research, Radboud University, Nijmegen, The Netherlands.
authors.forename: Jan-Kees
authors.initials: JK
authors.lastname: Helderman
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: Boer
authors.affiliation: Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Baltussen
mesh_terms: D020811:Biomedical Technology; D003657:Decision Making; D003659:Decision Making, Organizational; D003695:Delivery of Health Care; D019317:Evidence-Based Medicine; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D013673:Technology Assessment, Biomedical
keywords: Evidence-Informed Deliberative Processes; Fair Processes; HTA as Learning; Healthcare Technology Assessment (HTA); Priority Setting; Values