Recommendations for incorporating equity into HTA evaluation

Many health policy experts–including myself–have noted that treatments that help reduce health disparities may be especially valuable whereas those that exacerbate inequalities may be somewhat less valuable than predicted by standard cost-effectiveness analysis. A key question is, health disparities over what dimension(s)? Is it race? Income? Education? O’Nell et al. (2013) developed the PROGRESS framework.…

How do social determinants of health impact health outcomes?

There are many studies that show that social determinants of health (SDOH) impact health outcomes. A more challenging question is how do SDOH impact health outcomes? Specifically, through what pathways or mechanisms do SDOH operate? A paper by Thimm-Kaiser (2023) identifies 8 mechanisms through which SDOH impact outcomes. These include: SDOH are underlying causes of…

Distributional Cost Effectiveness Analysis: A simple example

I have written previously about the need for distributional cost-effectiveness analysis (DCEA) which would increase the value of treatments who improve the health for individuals who currently have the worst expected quality-adjusted life expectancy (QALE). I’ve written about this in AJMC and Health Affairs among other places. One key question many individuals may have is…

Steps Health Professionals Can Take to Reduce Inequality in Health Outcomes

That is the title of an article in AJMC co-authored with Meena Venkatachalam. An excerpt is below: While decision-makers traditionally have ignored the issue of inequality, academic researchers have already developed tools to quantify a treatment’s value from reductions in inequality. Two common methods for doing so are distributional cost effectiveness analysis (DCEA) and multiple-criteria…