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This editorial aims to outline the context of healthcare priority‐setting, and summarise each of the other ten papers in this special edition. It introduces a new multidisciplinary research programme drawing on ethics, philosophy, health economics, political science and health technology assessment, out of which the papers in this edition have arisen.

Key normative concepts are introduced and policy and research context provided to frame subsequent papers in the edition.

Common challenges of health priority‐setting are faced by many countries across the world, and a range of social value judgments is in play as resource allocation decisions are made. Although the challenges faced by different countries are in many ways similar, the way in which social values affect the processes and content of priority‐setting decisions means that those challenges are resolved very differently in a variety of social, political, cultural and institutional settings, as subsequent papers in this edition demonstrate. How social values affect decision making in this way is the subject of a new multi‐disciplinary research programme.

Technical analyses of health priority setting are commonplace, but approaching the issues from the perspective of social values and conducting comparative analyses across countries with very different cultural, social and institutional contexts provides the content for a new research agenda.

The purpose of this paper is to present the role of social values in setting healthcare priorities in Korea.

Using Clark and Weale's draft framework, Korean healthcare priority setting was analysed. The process values used were transparency, accountability, and participation, and the content values used were clinical effectiveness, cost effectiveness, justice/equity, solidarity and autonomy.

In the Korean health priority setting, it was found that multiple factors influence the decision‐making process. Effectiveness and safety are the two most important values mentioned in the process. Cost‐effectiveness is also considered in reimbursement decisions for new drugs since 2007. Recently, health technology assessment (HTA) has begun to change the social value system traditionally used in the Korean healthcare priority setting.

The paper extends understanding of health priority setting in Korea, and how the interpretation and use of social values has changed over recent years.

The purpose of this paper is to introduce the new US health organizations called accountable care organizations (ACOs) which are expected to improve the quality and reduce the cost of healthcare for Medicare enrolees. It assesses the importance of ACOs, defining and articulating the values that will underpin their strategic and clinical decision making.

This paper uses a social values framework developed by Clark and Weale to consider the values relevant to ACOs.

It is likely that social values could be made more explicit in a US setting than they have ever been before, via the new ACOs. Social values could start to form part of a local health economy's marketing strategy.

ACOs are very new. This paper identifies that they will need to be very explicit about the values relevant to them. The development of ACOs and the articulation of social values therein may even form the basis of a meaningful dialogue on the importance of assessing value for money or cost‐effectiveness in the wider US health policy environment.

The purpose of this paper is to demonstrate that the social values framework developed by Clark and Weale could be applied to publicly available data and to explore the concordance between the framework values and those present in the statements of decision‐making protocols of Health Technology Assessment Agencies.

The web sites of the National Institute for Health and Clinical Excellence (NICE); the All Wales Strategy Medicines Group; and the Scottish Medicines Consortium were searched for references to social value statements and assessed according to the social values framework.

The framework was easy to apply and demonstrated that it is possible to find statements of operational expression of a range of social values in the description of the decision protocols used by the public agencies. Most of the framework's values find some expression in the statements of the decision protocols, but there are differences. For example, the All Wales Group, when discussing clinical effectiveness, explicitly refers to an assessment via “pathways of care” in a way that neither of the other two do. The value of autonomy is explicitly mentioned by NICE but not by the other two, whereas the value of solidarity (a value most typically associated with European social insurance systems) finds only indirect expression in the guidance notes of all.

The paper provides further information that will be useful in revising the framework in preparation for its role in future data collection.

This is the initial step in developing a social values instrument that will support health policy decisions. While there are other check lists of social values, this is the first time that an approach to creating a framework is being tested empirically.

The purpose of this paper is to provide an overview of the organisational and procedural arrangements for priority setting in England and Wales. It describes the role of social values in the decision‐making process.

The processes and content of decisions made by the National Institute for Health and Clinical Excellence are analysed using the framework developed by Clark and Weale for identifying social values in health priority‐setting.

While countries are seeking to achieve similar outcomes from their health prioritisation processes, each country has established different systems that reflect the social and legal framework underpinning their health systems. England is somewhat unique in being explicit about assessing “value for money” and using formal cost‐effectiveness in developing policy.

Many countries are now considering the use of formal health economic methodologies to assess the value and prioritise health care interventions. However there is increasing recognition of the importance of values other than efficiency (cost effectiveness) in making acceptable decisions. This is manifest in the range of potential new approaches being developed including multiple criteria decision analysis.

It is commonly recognized that the setting of health priorities requires value judgements and that these judgements are social. Justifying social value judgements is an important element in any public justification of how priorities are set. The purpose of this paper is to review a number of social values relating both to the process and content of priority‐setting decisions.

A set of key process and content values basic to health priority setting is outlined, and normative analysis applied to those values to identify their key features, possible interpretations in different cultural and institutional contexts, and interactions with other values.

Process values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability, and “content” values are found often to be hidden in technical criteria. There is a complex interplay between value and technical components of priority setting, and between process and content values. Levels of economic development, culture and need will all play a part in determining how different systems balance the values in their decisions.

Technical analyses of health priority setting are commonplace, but approaching the issues from the perspective of social values is a more recent approach and one which this paper seeks to refine and develop.

Over the last five years many middle‐income Latin American countries have seen a steep increase in the number of cases litigating access to curative services. The purpose of this paper is to explore this complex phenomenon and outline some of its roots and impacts.

The authors use an interdisciplinary approach based on a literature review and workshops convened to discuss the issue.

A range of reasons can explain this increased legal activity. These include: a renewed judicial approach to the enforcement of the right to health; a more demanding public interest; an increased prevalence of non communicable diseases; and limited capacity for fair benefit package.

The findings in this paper argue for the need to incorporate a rights‐based approach to health policy as a foundation of societal efforts to achieve universal health coverage in Latin America.

New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations.

The paper employs a comparative case study approach. It explores the experience of four countries – Brazil, England, South Korea and the USA – in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes.

Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public.

The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

The purpose of this paper is to analyse the roles of social values in the reform of coverage decisions for Thailand's Universal Health Coverage (UC) plan in 2009 and 2010.

Qualitative techniques, including document review and personal communication, were employed for data collection and triangulation. All relevant data and information regarding the reform and three case study interventions were interpreted and analysed according to the thematic elements in the conceptual framework.

Social values determined changes in the UC plan in two steps: the development of coverage decision guidelines and the introduction of such guidelines in benefit package formulation. The former was guided by process values, while the latter was shaped by different content ideals of stakeholders and policymakers. Analysis of the three interventions suggests that in allocating its resources to subsidise particular services, the UC authority took into account not only cost‐effectiveness, but also budget impacts, equity and solidarity. These social values competed with each other and, in many instances, the prioritisation of benefit candidates was not led solely by evidence, but also by value judgments, even though transparency was recognised as an ultimate goal of reform.

The study findings indicate room for improvement and for future research – the current conceptual framework is inadequate to capture all the crucial elements which influence health prioritisation, as well as their interactions with social values.

The paper fills a gap in literature as it enhances understanding of the effects of social value judgments in real‐life health prioritisation.

The purpose of this paper is to provide an overview of the organisational and procedural arrangements for healthcare reform in China, and describe the role of social values in the relevant decision‐making process.

An analysis of recent developments aimed at achieving universal coverage in China was undertaken in the context of describing the influence of underlying social values.

The key underlying social value was found to be social solidarity. Other values were implicit rather than explicitly stated, and were subservient to the overall aim of comprehensive coverage.

The paper shows that China is embarking on the largest‐scale health reforms in the world. There is an eagerness to share experiences with other countries in an attempt to ensure the success of the reforms. There is an increasing understanding of the need to make the values underpinning the reforms more explicit and, in particular, those concerned with efficiency and appropriateness.