Health technology appraisal and the courts: accountability for reasonableness and the judicial model of procedural justice

Abstract

Recommendations issued by agencies undertaking appraisals of health technologies at the national level may impact upon the availability of certain treatments and services in some publicly funded health systems, and, as such, have regularly been subject to challenge, including by way of litigation. In addition to expertise in the evaluation of evidence, fairness of procedures has been identified as a necessary component of a claim to legitimacy in such circumstances. This article analyses the assessment of courts in three jurisdictions of the fairness of decision-making by such agencies and evaluates the judicial reading of procedural justice developed in this particular context against the conditions of 'accountability for reasonableness'.

Coverage Decisions and the Court: A Public Health Perspective on Glucosamine Reimbursement in Thailand

“…20 It is worth noting that in some cases, patients as individuals or associations, supported by the drug industry, file lawsuits to force the government payment for extremely expensive products. 21 Because the glucosamine coverage dispute in the CSMBS is the first case in Thailand where the judicial institution ruled over a health benefit policy and the judicialization of health benefits may expand due to consumers' and health professionals' increasing demands for high-cost technologies in light of health care resource constraints, we call upon concerned parties to discuss the appropriateness, relevance, and implications of different options for Court intervention in the future coverage decision. Given that courts in other countries have had notable experiences on similar issues, lessons learned from those settings will be helpful in informing the involvement of Thai courts in health coverage decisions.…”

Publish or be damned: Individual Funding Requests and the publicity condition

“…Some have questioned whether A4R's conditions encapsulate the requirements of procedural justice, whether it is an account of procedural justice15 and, most piercingly, whether it truly offers a route around substantive questions of distributive justice 16–18. Questions have been raised about the sufficiency of the conditions,15–17 19 20 their clarity and their practical application 15 16 18 21. However, there is little suggestion that the conditions that Daniels and Sabin have formulated are irrelevant to healthcare funding decision-making.…”

Republicanism and the Paradox of Public Health Preconditions Comments on Steve Latham

“…While the intervention of courts remains very controversial, both in general and amongst republicans (Pettit, 1999(Pettit, , 2012Bellamy, 2007), elsewhere I have argued they constitute an invaluable part of the public health policy process (Morales, 2015). Judicial review is by no means a full answer to Steve Latham's concerns, but introducing an additional voice through the judicial process nevertheless may promote contestation, expand participation, include alternative points of view, and generally broaden social debate (Syrett, 2011(Syrett, , 2014. Admittedly, existing judicial systems require substantial reform for the courts to effectively grant a robust voice to the people, and republican political theory will offer important guidelines to ensure courts play a proper role in legitimating public health interventions in a democratic society.…”