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Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage

Author

Listed:
  • Francesco Paolucci

    (Murdoch University
    University of Bologna)

  • Ken Redekop

    (National University of Singapore
    Erasmus University Rotterdam)

  • Ayman Fouda

    (University of Bologna
    Erasmus University Rotterdam)

  • Gianluca Fiorentini

    (University of Bologna)

Abstract

Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

Suggested Citation

  • Francesco Paolucci & Ken Redekop & Ayman Fouda & Gianluca Fiorentini, 2017. "Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 697-706, December.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:6:d:10.1007_s40258-017-0349-3
    DOI: 10.1007/s40258-017-0349-3
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    References listed on IDEAS

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    1. Cinzia Colapinto & Raja Jayaraman & Simone Marsiglio, 2017. "Multi-criteria decision analysis with goal programming in engineering, management and social sciences: a state-of-the art review," Annals of Operations Research, Springer, vol. 251(1), pages 7-40, April.
    2. Laurence J. Kotlikoff, 2005. "Who’s Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," Working Papers id:286, eSocialSciences.
    3. Shah, Koonal K. & Cookson, Richard & Culyer, Anthony J. & Littlejohns, Peter, 2013. "NICE's social value judgements about equity in health and health care," Health Economics, Policy and Law, Cambridge University Press, vol. 8(2), pages 145-165, April.
    4. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    5. Francesco Paolucci, 2011. "Economic Rationales for the Design of Health Care Financing Schemes," Developments in Health Economics and Public Policy, in: Health Care Financing and Insurance, chapter 0, pages 13-32, Springer.
    6. P. Thokala & A. Duenas, 2012. "Multiple Criteria Decision Analysis for Health Technology Assessment," Post-Print hal-00800398, HAL.
    7. Helen Dakin & Nancy Devlin & Yan Feng & Nigel Rice & Phill O'Neill & David Parkin, 2015. "The Influence of Cost‐Effectiveness and Other Factors on Nice Decisions," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1256-1271, October.
    8. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    9. Axel C. Mühlbacher & Anika Kaczynski, 2016. "Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 29-40, February.
    10. Christian Hagist & Laurence Kotlikoff, 2005. "Who's Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," NBER Working Papers 11833, National Bureau of Economic Research, Inc.
    11. Francesco Paolucci, 2011. "Health Care Financing and Insurance," Developments in Health Economics and Public Policy, Springer, number 978-3-642-10794-8, March.
    12. Michael P. Keane & Nada Wasi, 2013. "The Structure of Consumer Taste Heterogeneity in Revealed vs. Stated Preference Data," Economics Papers 2013-W10, Economics Group, Nuffield College, University of Oxford.
    13. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    14. Francesca Colombo & Nicole Tapay, 2004. "Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Papers 15, OECD Publishing.
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    Cited by:

    1. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.

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