Author: Rick Chapman, PhD, Chief Science Officer, IVI
How do we ensure that the data and methods used for value assessment adequately account for the diversity of patients and the urgent need to correct inequities in the health care system – and society in general?
Without explicit attention to these issues, health technology assessment (HTA) runs the risk of continuing or exacerbating inequity. In the IVI webinar, Methods in Value Assessment that Support Equity, we explored how equity impacts have (or have not) been included in prior cost-effectiveness analyses, ongoing initiatives related to newer methods that account for the equity impacts of health care interventions, and the need for additional data and methodologies to support decision-makers as they strive to improve equity in the provision of health care.
Primary data collection must reflect the diversity of affected populations. This may mean increased efforts to recruit specific groups into clinical trials or surveys, or the addition of data on social determinants of health to healthcare claims or other databases. And value assessments should include analyses that fully account for the richness of these data. Beyond trial or other clinical data, this may involve working with diverse populations to determine what matters most to them, and then measuring outcomes that reflect patients’ diversity in preferences.
As a researcher who conducts HTA, I’m convinced that methods accounting for equity must be fully incorporated as essential aspects, and no longer considered novel or non-essential. There is still much work to be done in refining methods and ensuring that relevant data are available. But value assessments that utilize existing methods and initiatives – such as those described in our webinar – can further our understanding of current inequities and the likely equity impacts of health care innovations. They can also point out blind spots in the data and methods that we need to rectify.
Finally, payers, employers, and policymakers, as the “consumers” of HTA, should demand that discussions of value include consideration of the equity impacts of health care interventions. They should also measure and ask for outcomes data that reflect the diversity of the affected individuals’ needs and preferences.
The increased attention to equity creates an opportunity for the field of health technology assessment to shift its focus and to see value from different perspectives. Let’s hope we can rise to the occasion.