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Link between Process and Appraisal in Coverage Decisions

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  • Katharina E. Fischer
  • Björn Stollenwerk
  • Wolf H. Rogowski

Abstract

Background. To achieve fair-coverage decision making, both material criteria and criteria of procedural justice have been proposed. The relationship between these is still unclear. Objective. To analyze hypotheses underlying the assumption that more assessment, transparency, and participation have a positive impact on the reasonableness of coverage decisions. Methods. We developed a structural equation model in which the process components were considered latent constructs and operationalized by a set of observable indicators. The dependent variable “reasonableness†was defined by the relevance of clinical, economic, and other ethical criteria in technology appraisal (as opposed to appraisal based on stakeholder lobbying). We conducted an Internet survey among conference participants familiar with coverage decisions of third-party payers in industrialized countries between 2006 and 2011. Partial least squares path modeling (PLS-PM) was used, which allows analyzing small sample sizes without distributional assumptions. Data on 97 coverage decisions from 15 countries and 40 experts were used for model estimation. Results. Stakeholder participation (regression coefficient [RC] =0.289; P = 0.005) and scientific rigor of assessment (RC = 0.485; P

Suggested Citation

  • Katharina E. Fischer & Björn Stollenwerk & Wolf H. Rogowski, 2013. "Link between Process and Appraisal in Coverage Decisions," Medical Decision Making, , vol. 33(8), pages 1009-1025, November.
    • Handle: RePEc:sae:medema:v:33:y:2013:i:8:p:1009-1025
    DOI: 10.1177/0272989X13490837
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    References listed on IDEAS

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