Role of Health Equity in Health Technology Assessment Processes: A Landscape Analysis of 13 Health Systems in Asia

Abstract

Objectives: This landscape analysis aimed to summarize the role of health equity in the health technology assessment (HTA) process (topic nomination, topic prioritization, assessment, appraisal, and decision making) in Asia. Methods: A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Results: Health equity was reported to be considered in most health systems’ HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use. Conclusions: Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.