TY - JOUR
T1 - Developing and piloting a context-specified ethics framework for health technology assessment
T2 - The South African Values and Ethics for Universal Health Coverage approach
AU - Krubiner, Carleigh B.
AU - Barsdorf, Nicola W.
AU - Goldstein, Susan J.
AU - Mosam, Atiya
AU - Potgieter, Sunita
AU - Distefano, Michael J.
AU - Tugendhaft, Aviva
AU - Merritt, Maria W.
AU - Li, Ryan
AU - Chalkidou, Kalipso
AU - Faden, Ruth R.
AU - Hofman, Karen J.
N1 - Publisher Copyright:
©
PY - 2022/3/8
Y1 - 2022/3/8
N2 - Objectives While ethics has been identified as a core component of health technology assessment (HTA), there are few examples of practical, systematic inclusion of ethics analysis in HTA. Some attribute the scarcity of ethics analysis in HTA to debates about appropriate methodology and the need for ethics frameworks that are relevant to local social values. The South African Values and Ethics for Universal Health Coverage (SAVE-UHC) project models an approach that countries can use to develop HTA ethics frameworks that are specific to their national contexts.Methods The SAVE-UHC approach consisted of two phases. In Phase I, the research team convened and facilitated a national multistakeholder working group to develop a provisional ethics framework through a collaborative, engagement-driven process. In Phase II, the research team refined the model framework by piloting it through three simulated HTA appraisal committee meetings. Each simulated committee reviewed two case studies of sample health interventions: opioid substitution therapy and either a novel contraceptive implant or seasonal influenza immunization for children under five.Results The methodology was fit-for-purpose, resulting in a context-specified ethics framework and producing relevant findings to inform application of the framework for the given HTA context.Conclusions The SAVE-UHC approach provides a model for developing, piloting, and refining an ethics framework for health priority-setting that is responsive to national social values. This approach also helps identify key facilitators and challenges for integrating ethics analysis into HTA processes.
AB - Objectives While ethics has been identified as a core component of health technology assessment (HTA), there are few examples of practical, systematic inclusion of ethics analysis in HTA. Some attribute the scarcity of ethics analysis in HTA to debates about appropriate methodology and the need for ethics frameworks that are relevant to local social values. The South African Values and Ethics for Universal Health Coverage (SAVE-UHC) project models an approach that countries can use to develop HTA ethics frameworks that are specific to their national contexts.Methods The SAVE-UHC approach consisted of two phases. In Phase I, the research team convened and facilitated a national multistakeholder working group to develop a provisional ethics framework through a collaborative, engagement-driven process. In Phase II, the research team refined the model framework by piloting it through three simulated HTA appraisal committee meetings. Each simulated committee reviewed two case studies of sample health interventions: opioid substitution therapy and either a novel contraceptive implant or seasonal influenza immunization for children under five.Results The methodology was fit-for-purpose, resulting in a context-specified ethics framework and producing relevant findings to inform application of the framework for the given HTA context.Conclusions The SAVE-UHC approach provides a model for developing, piloting, and refining an ethics framework for health priority-setting that is responsive to national social values. This approach also helps identify key facilitators and challenges for integrating ethics analysis into HTA processes.
KW - Deliberative decision-making
KW - Ethics
KW - Ethics frameworks
KW - Health technology assessment
KW - Methodology
KW - National Health Insurance
KW - Priority-setting
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U2 - 10.1017/S0266462322000113
DO - 10.1017/S0266462322000113
M3 - Article
C2 - 35256036
AN - SCOPUS:85126746074
SN - 0266-4623
VL - 38
JO - International journal of technology assessment in health care
JF - International journal of technology assessment in health care
IS - 1
M1 - 2000113
ER -