Bargaining, Fairness, and Social Preferences: Understanding Decision-Making in Australian Health Technology Assessment

With rising costs, rapid technological change, and growing demand for high-quality care, health systems face mounting pressure to allocate limited resources fairly and efficiently. This thesis examines how ‘value’ is defined and operationalised in Australia’s health technology assessment (HTA) system. Through three studies, it reveals how cost-effectiveness is shaped by strategic negotiation, procedural fairness, and implicit social values. Focusing on the PBAC and MSAC, the research highlights HTA as a hybrid model that combines technical assessment with negotiation, institutional norms, and societal values, and argues for methods that better reflect real-world complexity and evolving public expectations.