OBJECTIVES: Health equity (HE), is the absence of avoidable or remediable differences among groups of people, either defined socially, economically, demographically or geographically. The influence of HE in health technology assessments is increasingly being acknowledged, which highlights the need for identifying methods to incorporate HE considerations into value-based assessments.

METHODS: An environmental scan of peer reviewed publications indexed in Embase/Medline during the last 10 years presenting frameworks targeting HE considerations in health-care decision making was conducted. In parallel, websites of key North American and European Union (EU) decision makers and international organizations were searched. Findings were grouped according to the key steps during a technology’s assessment (such as scoping, specification of decision problem, evidence synthesis, clinical and/or economic comparative assessments, other) using a pre-designed form. Results were synthesized qualitatively.

RESULTS: Database and supplementary searches retrieved 2662 records and 12 documents respectively. At 80% screening completed, 20 publications, predominantly US-based, were included. Relevant HE frameworks and checklists include the following: WHO Integrate, Health for All, PROGRESS/Plus, GRADE's Evidence to Decision, Systematic Equity Action-Analysis, Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity checklist, Population Health Index. In addition, key US organizations such as ICER, ASCO and Duke Margolis published specific HE frameworks. Common themes across these frameworks were the need for systematic, evidence-based data collection and synthesis across diverse populations for topics such as baseline risk differences. Limited references regarding analytical approaches (e.g. equity weighting, simulation exercises) to quantify HE impacts in technologies assessments were identified.

CONCLUSIONS: Expanding analytical capabilities and technical elements in existing HE frameworks may facilitate their integration in current policy making systems. With the imminent EU HTA legislation, there is an opportunity for European health systems to make progress by setting up the processes for ensuring decision-making results translate into patient-centric, equitable and sustainable health care.