Healthcare & Technologies

Biography

Biography: Leonor Varela Lema

Abstract

Statement of the Problem: Rationalizing healthcare resources constitutes a fundamental challenge to all health care systems. The current work, Commissioned by the Spanish Ministry of Health, was carried out with the purpose of developing an explicit priority setting methodology to support decision making regarding the technologies to be assessed for inclusion in the Spanish NHS service portfolio.

Methodology & Theoretical Orientation: The main aim of the work was to identify and analyse the criteria, approaches and conceptual frameworks used for priority setting internationally which could serve as basis for the development of the national priority-setting framework. For this purpose, a systematic search of the main biomedical electronic databases was performed and additional sources such as web pages of international health technology assessment agencies consulted.

Findings: In general terms, it was found that there are no standardised processes for priority setting, although some consensus and common trends have been identified regarding key elements (criteria, models and strategies, key actors, etc.). Globally, 8 key domain were identified: 1) Need for intervention; 2) Outcomes of intervention; 3) Type of benefit; 4) Economic consequences; 5) Existing knowledge/quality of evidence and uncertainties; 6) Implementation complexity/feasibility; 7) Priority, justice and equity and 8) Context. HTA agencies that were directly involved in supporting coverage decision making considered from 4-12 criteria.

Conclusion & Significance: The following work provides a thorough analysis of the relevant issues and offers recommendations regarding considerations for implementing successful HTA based prioritisation approaches. Findings are envisioned to be useful for different public organisations that are aiming to establish health care priorities.

Recent Publications

1. Goetghebeur MM, Wagner M, Khoury H, et al. Bridging health technology assessment (HTA) and efficient health care decision making with multicriteria decision analysis (MCDA): applying the EVIDEM framework to medicines appraisal. Med Decis Making. 2012;32:376-88.
2. Tanios N, Wagner M, Tony M, et al. Which criteria are considered in healthcare decisions? insights from an international survey of policy and clinical decision makers. Int J Technol Assess Health Care. 2013;29:456-65
3. Devlin NJ, Sussex J. Incorporating multiple criteria in HTA. Methods and processes. London 2011
4. Tromp N, Baltussen R. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers. BMC Health Serv Res. 2012;12:454
5. Golan O, Hansen P, Kaplan G, et al. Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights? Health Policy. 2011;102:126-35