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Health Technology Funding Decision-Making Processes Around the World: The Same, Yet Different

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Author Info

  • Tania Stafinski

    (School of Public Health, University of Alberta, Edmonton, Alberta, Canada)

  • Devidas Menon

    (School of Public Health, University of Alberta, Edmonton, Alberta, Canada)

  • Donald J. Philippon

    (School of Public Health, University of Alberta, Edmonton, Alberta, Canada)

  • Christopher McCabe

    (Academic Unit of Health Economics, University of Leeds, Leeds, UK)

Abstract

All healthcare systems routinely make resource allocation decisions that trade off potential health gains to different patient populations. However, when such trade-offs relate to the introduction of new, promising health technologies, perceived 'winners' and 'losers' are more apparent. In recent years, public scrutiny over such decisions has intensified, raising the need to better understand how they are currently made and how they might be improved. The objective of this paper is to critically review and compare current processes for making health technology funding decisions at the regional, state/provincial and national level in 20 countries. A comprehensive search for published, peer-reviewed and grey literature describing actual national, state/provincial and regional/institutional technology decision-making processes was conducted. Information was extracted by two independent reviewers and tabulated to facilitate qualitative comparative analyses. To identify strengths and weaknesses of processes identified, websites of corresponding organizations were searched for commissioned reviews/evaluations, which were subsequently analysed using standard qualitative methods. A total of 21 national, four provincial/state and six regional/institutional-level processes were found. Although information on each one varied, they could be grouped into four sequential categories: (i) identification of the decision problem; (ii) information inputs; (iii) elements of the decision-making process; and (iv) public accountability and decision implementation. While information requirements of all processes appeared substantial and decision-making factors comprehensive, the way in which they were utilized was often unclear, as were approaches used to incorporate social values or equity arguments into decisions. A comprehensive inventory of approaches to implementing the four main components of all technology funding decision-making processes was compiled, from which areas for future work or research aimed at improving the acceptability of decisions were identified. They include the explication of decision criteria and social values underpinning processes.

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Bibliographic Info

Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

Volume (Year): 29 (2011)
Issue (Month): 6 ()
Pages: 475-495

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Handle: RePEc:wkh:phecon:v:29:y:2011:i:6:p:475-495

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Web page: http://pharmacoeconomics.adisonline.com/

Related research

Keywords: Decision-making; Formularies.;

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Cited by:
  1. Axel Mühlbacher & Christin Juhnke, 2013. "Patient Preferences Versus Physicians’ Judgement: Does it Make a Difference in Healthcare Decision Making?," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 163-180, June.
  2. Fischer, Katharina Elisabeth, 2012. "A systematic review of coverage decision-making on health technologies—Evidence from the real world," Health Policy, Elsevier, vol. 107(2), pages 218-230.
  3. Fischer, Katharina E. & Rogowski, Wolf H. & Leidl, Reiner & Stollenwerk, Björn, 2013. "Transparency vs. closed-door policy: Do process characteristics have an impact on the outcomes of coverage decisions? A statistical analysis," Health Policy, Elsevier, vol. 112(3), pages 187-196.
  4. Hipgrave, David B. & Alderman, Katarzyna Bolsewicz & Anderson, Ian & Soto, Eliana Jimenez, 2014. "Health sector priority setting at meso-level in lower and middle income countries: Lessons learned, available options and suggested steps," Social Science & Medicine, Elsevier, vol. 102(C), pages 190-200.

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