This landscape analysis aimed to summarize the role of health equity in the health technology assessment (HTA) process (topic nomination, topic prioritization, assessment, appraisal, and decision making) in Asia.
A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam.
Health equity was reported to be considered in most health systems’ HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use.
Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.
This research focuses on how health equity is integrated into the health technology assessment (HTA) processes across 13 Asian health systems. Understanding health equity is vital because it ensures fair access to healthcare for all, addressing disparities that exist due to socioeconomic status, geography, and specific health conditions. The study found that while many Asian health systems recognize health equity in their HTA processes, the extent and methods of integration vary significantly.
Most health systems, except for Cambodia and Myanmar, have begun to incorporate health equity into various stages of HTA, such as topic nomination, prioritization, assessment, appraisal, and decision making. Countries like China and Japan often consider health equity when addressing diseases that heavily burden certain populations, including children and the elderly. In contrast, Indonesia and the Philippines focus on equity issues related to access for socially disadvantaged groups and different geographical locations.
The research identified that health equity is often used to prioritize health topics, particularly those affecting marginalized communities. However, the quantitative evaluation of health equity impacts is still in its early stages across most countries. Only a few nations have started using equity-informative economic evaluations designed to quantify equity impacts.
Key findings highlight that while health equity is acknowledged in the assessment and decision-making phases of HTA, there is a lack of systematic approaches to ensure that equity considerations are consistently applied. The study emphasizes the need for clearer guidelines and more robust frameworks to guide the integration of health equity in HTA processes.
In summary, this research underscores the importance of health equity in improving healthcare accessibility and quality in Asia. It points to the need for ongoing development of methods and standards to enhance the integration of health equity into HTA, ultimately leading to better health outcomes for diverse populations across the region.