This commentary responds to the article by Goetghebeur et al., which applies the EVIDEM (Evidence and Value: Impact on DEcision-Making) framework to evaluate growth hormone therapy for Turner syndrome patients. While we value the qualities of the EVIDEM because of its scope and breadth, we have doubts on the results consistency of the EVIDEM to compare competing interventions, particularly when setting priorities across broad healthcare service areas (e.g. in designing the national health benefit package) for two main reasons. First, the EVIDEM framework ignores the contextual nature of priority setting process by assuming a set of universal priority setting criteria. Secondly, the EVIDEM is vulnerable to interventions ranking inconsistency where performance evaluation of a broad range of competing interventions is mandated. To address its limitations, we propose a stepwise process to identify criteria and their weights, and rank ordered interventions.