Beyond cost-effectiveness: A five-step framework for appraising the value of health technologies in Asia-Pacific

Int J Health Plann Manage. 2020 Jan;35(1):397-408. doi: 10.1002/hpm.2851. Epub 2019 Jul 9.


Given resource constraints and the potential for increasingly high-cost, cost-effective medicines to become available, policymakers require strategies that go beyond cost-effectiveness when making resource allocation decisions. This manuscript presents a five-step framework that complements traditional health technology assessment (HTA) guidance documents that policymakers in Asia-Pacific and elsewhere may consider when setting up HTA guidelines and/or evaluating whether or not to subsidize a medicine or other health innovations. The framework recommends that subsidy decisions be based on five criteria: the relative burden of the condition as compared with other conditions (step 1), comparative and cost-effectiveness of the medicine (steps 2 and 3), the short-term impact on the budget (step 4), and other considerations including patient and societal preferences (step 5). Our approach, which is a complement to traditional HTA guidance documents, is not prescriptive but provides an evidence-based framework that HTA agencies in Asia-Pacific can follow as they aim to deliver value-based medicines to their constituents.

Keywords: cost-benefit analysis; health economics; health technology assessment; resource allocation.

MeSH terms

  • Asia, Eastern
  • Asia, Southeastern
  • Budgets
  • Cost of Illness
  • Cost-Benefit Analysis*
  • Humans
  • Technology Assessment, Biomedical / methods*
  • Technology Assessment, Biomedical / organization & administration
  • Treatment Outcome

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