INTRODUCTION: Health inequalities can be described as avoidable, systematic and unjust differences in health between different groups within society. This research described and evaluated potential methods to measure impacts of health inequalities that could be used in health technology assessment (HTA) in the UK. The research included recommendations for current and future policy objectives relating to incorporating health inequalities.
METHODS: A targeted literature review was conducted to identify methodological approaches used to incorporate health inequalities in HTA. Stakeholder interviews and a workshop were conducted with a range of UK stakeholders. This engagement aimed to discuss any gaps in the literature, and consider if attitudes, methods and policies were evolving at the same rate as the literature. Other aims of the engagement included the reflection of stakeholder views on health inequalities and better understanding the perspectives of decision makers.
RESULTS: Five potential methods were identified to account for health inequalities, with equity-based weighting and distributional cost-effectiveness analysis considered the most feasible of the methods for quantification. Stakeholders reiterated that a deliberative process should remain the centre of HTA. Stakeholders also raised issues such as the burden on committees, trade-offs between complexity and accessibility, and the importance of measuring the size and direction of inequality impacts. Recommendations were then produced based on these findings to better account for inequalities in HTA, highlighting the importance of combining a range of approaches.
CONCLUSIONS: Both companies and HTA agencies should be more proactive in accounting for health inequalities. Companies should be encouraged to provide quantitative analysis on health inequalities, while decision makers should be trained on new methods. Despite the recent rise in quantitative methods, qualitative methods remain extremely important for a ‘layered’ approach to considering health inequalities.