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Addressing Health System Values in Health Technology Assessment: The Use of Evidence-Informed Deliberative Processes

  • Wija Oortwijn (a1) and Philip Klein (a2)


Health technology assessment (HTA) is increasingly used around the globe to inform resource allocation decisions. Furthermore, the importance of using explicit and transparent criteria for coverage decision making in line with health system values has been acknowledged. However, the values of a health system are often not explicitly taken into account in the HTA process. This situation influences the allocation of scarce resources and could lead to a discord between the HTA outcome and the values of the health system. We describe how evidence-informed deliberative processes (EDPs) can help to improve this situation. EDPs are integrating two theoretical frameworks; multi-criteria decision-analysis and accountability for reasonableness. Through the use of EDPs, HTA agencies can ensure that health system values are more explicitly and consistently taken into account in the HTA process, enhancing the legitimacy of coverage decisions.


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Author for correspondence: Wija Oortwijn, E-mail:


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We are thankful for the valuable comments and suggestions from the anonymous reviewers. They have encouraged significant improvement of the manuscript. The time for writing this Perspective was funded by a grant from Eli Lilly and Company (i.e., Lilly Corporate Center, Indianapolis, USA). The funding organization did not place any restrictions on the content of the manuscript. W.O., the corresponding author, confirms that she had final responsibility for decision to submit for publication.



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