{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:59:42Z","timestamp":1780981182869,"version":"3.54.1"},"reference-count":112,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Precision medicine has moved into routine practice, but its evaluation through Health Technology Assessment (HTA) remains ethically underdeveloped. Existing instruments do not address the distinctive ethical demands of genomic profiling, AI-based clinical decision-support, and the equitable distribution of benefits from high-cost targeted therapies. Methods: A modified two-round Delphi study was conducted with a multidisciplinary panel of 18 Greek experts in bioethics, HTA, genomic medicine, nursing, and health policy. In Round 1, 32 candidate ethical statements across seven thematic domains were rated on a three-point scale; retention required a Content Validity Ratio (CVR) \u2265 0.42 and \u226580% agreement. Retained statements were re-evaluated in Round 2 with consensus defined as median \u2265 2.0 and \u226580% agreement. Reporting follows ACCORD guidelines. Results: Fifteen of 32 statements satisfied retention criteria. In Round 2, all 15 achieved consensus with a median of 3.0 and agreement of 94.4\u2013100% (interquartile range, IQR = 0.00). Five domains constituted the final framework: fundamental ethical principles; transparency, stakeholder participation, and institutional accountability; equity and access; digital health and artificial intelligence (AI); and pandemic preparedness and system resilience. Domains addressing environmental sustainability and social acceptability did not meet the threshold. Conclusions: This study presents, to our knowledge, one of the first empirically grounded ethical frameworks for precision medicine HTA developed within an EU Member State through a formal Delphi process. The framework is operationalised through a ready-to-use ethics checklist designed for direct integration into national HTA submission and appraisal processes. Conducted in Greece\u2014a late-aligning EU Member State\u2014the study provides a transferable methodological template for comparable health systems across Europe.<\/jats:p>","DOI":"10.3390\/jpm16060308","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:18:16Z","timestamp":1780679896000},"page":"308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethical Considerations in Health Technology Assessment for Precision Medicine: A Delphi Study in a Greek Setting"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3636-3944","authenticated-orcid":false,"given":"Nikolaos","family":"Veskoukis","sequence":"first","affiliation":[{"name":"Department of Nursing, University of Patras Campus, 26504 Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5585-9379","authenticated-orcid":false,"given":"Nikos","family":"Stefanopoulos","sequence":"additional","affiliation":[{"name":"Department of Nursing, University of Patras Campus, 26504 Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Naoum","sequence":"additional","affiliation":[{"name":"Laboratory for Health Technology Assessment (LabHTA), University of West Attica, Alexandras Av. 195, 11521 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1024-3802","authenticated-orcid":false,"given":"Kostas","family":"Athanasakis","sequence":"additional","affiliation":[{"name":"Laboratory for Health Technology Assessment (LabHTA), University of West Attica, Alexandras Av. 195, 11521 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1017\/S0266462320000215","article-title":"The new definition of health technology assessment: A milestone in international collaboration","volume":"36","author":"Oortwijn","year":"2020","journal-title":"Int. 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