Value in Health Themed Section Publishes 10 Papers Addressing the Demand for Evidence on Equity in Health Economic Evaluation

Lawrenceville, NJ, USA—June 24, 2025—Value in Health, the official journal of ISPOR—The Professional Society for Health Economics and Outcomes Research, announced today the publication of a special themed section of research papers that offer new tools to help health policy makers weigh fairness alongside cost-effectiveness when deciding which treatments and programs to fund. Guest editors for the themed section are Susan Griffin, PhD, University of York, United Kingdom; Sabine E. Grimm, PhD, MSc, Maastricht University, The Netherlands; and Julia F. Slejko, PhD, University of Maryland, United States. The series was published in the June 2026 issue of Value in Health.

“You may struggle to find anyone who would disagree with the notion that equity is a fundamental component of value in health and healthcare," noted Griffin, Grimm, and Slejko in their opening editorial. “However, ask people to define exactly what fairness means and how we might operationalize it in research to support our health systems, and you may equally struggle.” This themed section spotlights the methods, measures, and data needed to bring equity considerations into routine health economic evaluation.

The themed section includes 10 research papers in 3 clusters:

Cluster 1: New methods for embedding equity in decision making

1. "The Inequality-Adjusted Incremental Cost-Effectiveness Ratio," by Cookson R, Kaur G, Skarda I, and colleagues
2. "A Threshold Inequality Aversion Parameter Approach to Interpret Distributional Cost-Effectiveness Analysis Results," by Pandya A, Zhu J, Luviano A, James LP, and Goshua G

Cluster 2: Social preferences concerning unfair health inequality

1. "Why Object to Inequalities in Health and Well-Being? A Mixed-Methods Exploration of Inequality Aversion With Members of the General Public," by Field B, Smith KE, Wickramasekera N, and Tsuchiya A
2. "A Systematic Review of Elicitation Methods for Distributional Preferences in Healthcare Regarding the Concentration and Dispersion of Health Benefits," by Trigg LA, Moolla A, Angus C, and Tsuchiya A
3. "Validity, Reliability, and Framing Effects in Equity-Efficiency Trade-Off Studies: A Systematic Review," by Chechulina V, Chu A, Lam QH, Kabir-Bahk C, and Ali S
4. "Strengthening Methods and International Evidence on Health Inequality Aversion," by Boujaoude MA, Devlin NJ, Doran T, Hurley J, and Cookson R

Cluster 3: Data requirements to assess equity impacts

1. "The Social Distribution of Quality-Adjusted Life Expectancy Among Social Deprivation Subgroups in China," by He X, Dong P, Xin Y, and colleagues
2. "Incorporating Equity and Financial Protection Criteria Into Essential Benefits Package Design: A Case Study of Infectious Diseases Interventions in Ethiopia," by Assebe LF, Jiao B, Hendrix N, Tolla MT, and Verguet S
3. "Value-Based Pricing of Health Services With Health Equity Considerations," by Siciliani L, Walker S, Glynn D, Gao N, Gutacker N, Doran T
4. "Dominance-Based Distributional Cost-Effectiveness Analysis of Cardiovascular Disease Risk Screening in Sri Lanka," by Wijemunige N, van Baal P, Rannan-Eliya RP, and O'Donnell O

Together, the papers contribute key findings across the 3 area clusters:

• New methods are emerging to embed equity directly into decision making, including approaches that adjust the incremental cost-effectiveness ratio or policy threshold to reflect equity concerns and define ranges of inequality aversion that can guide prioritization when precise societal preferences are not available.

   

• Social preferences concerning unfair health inequality are receiving renewed attention. Wealth inequalities are perceived as more visible than health inequalities, and fairer distributions are often seen as benefiting everyone. Aversion to inequality may vary with the size of per-person health gains, and most published studies have not adequately tested the validity, reliability, or framing effects of inequality aversion estimates—gaps that an emerging international research agenda aims to close.

   

• The data requirements needed to assess equity impacts are also being addressed. New analyses generate baseline estimates of health disparities, evaluate trade-offs between health gains, equity, and financial protection in essential benefits package design, incorporate inequality aversion into pay-for-performance schemes, and demonstrate that dominance-based methods can identify welfare-improving policy changes without precisely specifying inequality aversion.

"The routine incorporation of equity into value assessment can be managed through the continued development and standardization of methods,” note the guest editors. "We call for both greater adoption of existing equity methods and measures and sustained investment in their further methodological development."

Further Reading:

• Combining Simulation Model-Based Outcomes With County-Level Data for Geographic Health Equity Impact Evaluations of New Interventions
• Adapting a Benefit Trade-Off Instrument to Measure Health Inequality Aversion in the United States
• Primer on Health Equity Research in Health Economics and Outcomes Research: An ISPOR Special Interest Group Report
• Distributional Cost-Effectiveness Analysis in Genomic Medicine: Considerations for Addressing Health Equity
• What Role Does Equity Play in Australia’s Health Technology Assessment Processes? A Review of the Pharmaceutical Benefits Advisory Committee Recommendations Regarding Vaccines
• Role of Health Equity in Health Technology Assessment Processes: A Landscape Analysis of 13 Health Systems in Asia

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ABOUT ISPOR 
ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE^®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field. 
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ABOUT VALUE IN HEALTH 
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s current impact factor score is 6.0 and its 5-year impact factor score is 5.7. Value in Health is ranked 5th of 124 journals in Health Policy and Services, 12th of 185 journals in Health Care Sciences & Services, and 37th of 617 journals in Economics. Value in Health is a monthly publication that circulates to more than 55,000 readers around the world. 
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