EUnetHTA Adaptation Glossary (beta)

Description of the concept

The concept of affordability is related to the capacity of being affordable. Something is affordable when one can manage it in terms of time, money or resources.
There is another context in which this term is used, which is related to the capacity to provide something.
In HTA it should be a criteria to take into account when one has to make decisions about inclusión or exclusion of some intervention, treatment or diagnostic procedure, by the means of being able to cope within the budget and resources of each country.

Affordability is the capability to allocate financial funds to an individual or societal need. Thus, we see a need to differ between a society’s capability to afford a health technology and the individual capability to afford a health technology which is not financed by the health care system / health insurance. The affordability is closely related to the idea of choice. Affordability has different degrees, depending on the allocation and trade-offs.

Affordability describes the means a nation / health care system has at its disposal and could allocate to a particular purchase (service). This has nothing to do with the actual decision whether to purchase or not, as this would depend on, amongst other things, the relative and absolute values of the goods.

The main aim of determining affordability in the health care sector is to evaluate whether the expenses of the intervention can be met.

In addition to an intervention's effectiveness, decision-making requires consideration of the intervention's feasibility, sustainability and affordability. Affordability also tells us something about the value of alternative health-care services.

While considering affordability, it is important to take into account all possible costs and consequences of an intervention.

There is no standard definition of affordability, as it relates to the extent a patient or a service provider can pay for it. This will for example depend on the funding mechanism/income level and the cost of service. What is affordable health care in one country is not necessarily affordable in another country.

Here I am afraid that we cannot give any insights from a Danish setting, since it is not a term which is often used (except perhaps in economic contexts). Also we are not sure about the specific relation to adaptation. This answer might not seem very productive, but we need to consider whether it is relevant in relation to adaptation. We endorse the general descriptions, even though it could have many different meanings (affordability of an HTA-project, a technology etc.).