in the editorial published in this journal, daniels and colleagues argue that his and sabin’s accountability for reasonableness (a4r) framework should be used to handle ethical issues in the health technology assessment (hta)-process, especially concerning fairness. in contrast to this suggestion, it is argued that such an approach risks suffering from the irrrelevance or insufficiency they war...

OBJECTIVE Limited resources mean that decision-makers must set priorities among competing opportunities. Programme budgeting and marginal analysis (PBMA) is an economic approach that focuses on optimizing benefits with available resources. Accountability for reasonableness (A4R) is an ethics approach that focuses on ensuring fair priority-setting processes. PBMA and A4R have been used separatel...

In resource-poor settings, the accountability for reasonableness (A4R) has been identified as an important advance in priority setting that helps to operationalize fair priority setting in specific contexts. The four conditions of A4R are backed by theory, not evidence, that conformance with them improves the priority setting decisions. This paper describes the healthcare priority setting proce...

Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are...

In the editorial published in this journal, Daniels and colleagues argue that his and Sabin's accountability for reasonableness (A4R) framework should be used to handle ethical issues in the health technology assessment (HTA)-process, especially concerning fairness. In contrast to this suggestion, it is argued that such an approach risks suffering from the irrrelevance or insufficiency they war...

Abstract Background The “Accountability for Reasonableness” (A4R) framework has been widely adopted in working towards equity health sub-Saharan Africa (SAA). Its suitability equitable policy hinges, at least part, on its considerable successes the United States and it being among most comprehensive ethical approaches addressing inequitable access to healthcare. Yet, conceptual match is yet be ...

In the editorial published in this journal, Daniels and colleagues argue that his and Sabin’s accountability for reasonableness (A4R) framework should be used to handle ethical issues in the health technology assessment (HTA)-process, especially concerning fairness. In contrast to this suggestion, it is argued that such an approach risks suffering from the irrrelevance or insufficiency they war...

BACKGROUND Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four condition...

BACKGROUND Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for ...

Governments can be accountable for improving the fairness of their priority setting through enhanced transparency and stakeholder engagement. A case analysis is conducted of priority setting in a government health care context in Ontario, Canada, assessing how implementation of hospital accountability agreements meets the conditions of a leading international ethical framework for priority sett...