Michael Schlander
1,2*
1 German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), & University of Heidelberg, Heidelberg, Germany.
2 Institute for Innovation & Valuation in Health Care (InnoValHC), Wiesbaden, Germany
Abstract
There are at least two reasons why health technology assessment (HTA) agencies need to seek process-based solutions to support the legitimacy of healthcare resource allocation, ie, (i) in pluralistic societies, the existence of often conflicting and incommensurable claims (ie, the “fragmentation of value”) and the lack of a broadly accepted, ethically defensible analytical framework, and (ii) the well-documented loopholes of the conventional logic of cost-effectiveness (CE) with its reductionist concept of allocative efficiency, which fails to reflect the distributive dimension of resource allocation decisions in collectively financed health schemes.