OBJECTIVES: Whether it is possible to ground health technology assessment on egalitarian social justice theory is an ongoing debate. This study aims to contribute to answer this question as it is focussed on concrete application of equivalent income approach that has been developed by M. Fleurbaey (2007) and aiming to include inequality aversion in cost/benefit analysis. The objective is to prove its feasibility in the context of public decision making. For this first application case, it has been chosen to focus on the economic assessment of antihypertensive treatments for patients with essential hypertension. METHODS: The method is based on the comparison of two social welfare functions: social welfare function in terms of individuals’ equivalent incomes when antihypertensive treatments are prescribed in primary prevention (SWA) and social welfare function in terms of individuals’ equivalent incomes when there is no antihypertensive treatment in primary prevention (SWB) . If SWA −SWB >0, then it would be considered that antihypertensive treatments in primary prevention are welfare improving compared to the “do nothing” strategy. To collect the information needed to process to this assessment, two databases are used: a survey focused on equivalent incomes (n=3331) in a representative sample of the French population and a cost-effectiveness model produced by the French National Authority for Health (HAS). RESULTS: As preliminary results, we find that antihypertensive treatments in primary prevention are efficient if the inequality aversion is 0, 1 or 2. However antihypertensive treatments are not efficient anymore if it is decided to take a stronger degree of inequality aversion of 3. Indeed, 20% of the poorest individuals would have an increase of income if antihypertensive treatment were not prescribed and reimbursed by the national health insurance given their actual participation to public health care expenses. CONCLUSIONS: These results may reflect issues raised by the funding of health care in the French sytem.