Integrating ethical analysis in health technology assessment: opportunities and challenges

Ethics has been recognized as an integral part of Health Technology Assessment (HTA) since its beginning. However, the integration of ethical analysis in HTA practice has been limited and challenging. Members of the Health Technology Assessment international (HTAi) Interest Group (IG) for Ethical Issues in HTA reflected upon this situation, during a workshop and online meetings, to identify which challenges hinder integration of ethics in HTA and how to move the discipline forward. In this article, we present the results of that discussion, describing different ways that ethical analysis can occupy a more central role in HTA practice. We also describe developments in HTA that create a momentum for reflecting upon such integral role for ethical analysis in HTA: artificial intelligence-based health technologies, changes in the evidence landscape, assessing the environmental impact of health technology, and the new EU regulation on HTA.