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

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.