Improving Consumer Engagement in Health Technology Assessment and Decision Making: Lessons from 'Values in Science'.

Health technology assessments (HTA) and related decision making by regulators, payers and clinical policymakers (henceforth HTA-DM) are not simply technical processes, but normative ones, shaped by economic, moral, and scientific values. Since these value-laden decisions affect consumers, it is broadly accepted that their values need to be taken into consideration in HTA-DM and that they should be actively engaged in some aspects of these processes. This paper begins by examining current approaches to consumer engagement in HTA-DM. We then identify key challenges inherent in meaningful consumer participation, including procedural obstacles, representation issues, and difficulties in values interpretation. After briefly reviewing existing responses to these challenges, we demonstrate how insights from the philosophy of science-particularly scholarship on values in scientific inquiry-can provide new insights into the challenges of integrating consumers' values into HTA-DM and offer some strategies for more targeted and effective consumer involvement.