OBJECTIVES: Identify best practices to ensure health equity is integrated into health technology assessment (HTA).

METHODS: In December 2022 and January 2023, the Innovation and Value Initiative (IVI) convened two virtual roundtables including discussants representing lived experience, patient advocacy organizations, researchers, payers, clinicians, and industry. Drawing from their expertise, review of published literature, and previous key informant interviews, the roundtables identified best practices within the context of domains essential to equity in HTA, including: “power, people and processes” (addressing power imbalances in HTA), “methods to measure and address equity impacts,” “data, inputs and infrastructure,” and “communication of HTA.”

RESULTS: A recurring focus was the need for reframing power and representative participation in HTA, and demand for solutions and accountability for change in processes and methods used. Specific emerging themes included:

• Patient/caregiver expertise and lived experience must be considered on par with other expertise, with co-investigator roles prioritized for people affected by HTA.
• Transparency, inclusiveness, and accountability are essential for meaningful change in HTA.
• Researchers and users of HTA should prioritize qualitative and mixed methods where appropriate.
• Data and analyses should include elements identified as important by patients and reflect perspectives of marginalized patient communities.
• HTA must incorporate appropriate methods to advance equity that are understandable and accessible to multiple stakeholders.
• HTA models should highlight data and infrastructure gaps and prioritize research questions that advance equity rather than “building models to data.”

CONCLUSIONS: The roundtables identified best practices, grouped into 1) near-term actions; 2) actions requiring further exploration, testing or development; and 3) up- and down-stream actions requiring leadership and resources that exist outside HTA. Near-term actions focus more on process, power, and accountability measures, as well as testing existing methods and approaches. However, wider attention to stakeholder roles and collaborative responsibilities of researchers and policy makers is needed for change.