Revealed and Stated Preferences of Decision Makers for Priority Setting in Health Technology Assessment: A Systematic Review

Abstract

This review found trust in the clinical evidence and, where applicable, cost-effectiveness were important for decision makers. Many methodological differences likely contributed to the diversity in some of the other findings across studies of the same committee. Further work is needed to better understand how competing factors are valued by different HTA committees.

Development of the WHO-INTEGRATE evidence-to-decision framework: an overview of systematic reviews of decision criteria for health decision-making

“…Three reviews explored criteria used to guide investment or disinvestment decisions [22,27,37]. Two reviews assessed criteria to guide the selection of topics for HTA [8,34], and eight reviews captured criteria used in HTA [8,11,19,20,31,32,48]. Four reviews focused specifically on the evaluation of or decisions on vaccines [4,21,47,55].…”

“…distribution of adverse events across all those affected by the intervention) or as an outcome (e.g. reduced health inequity several years Uptake of intervention [15,20,34,35] Magnitude of benefit/effect/impact [2,4,11,14,18,31,33,36] Additional or indirect effects [2,6,33,34] Type and composition of effect/ benefit/impact [2] Impact on mortality, survival, longevity and life expectancy [1, 2, 4, 11, 16, 19, 21, 24-26, 28, 34-36] Last chance therapies [23,24] Impact on morbidity and disability [1,2,16,35] Potential changes in health consequences [24,25] Impact on (health-related) quality of life [2,8,11,12,14,19,20,22,25,26,28,29,31,33,35,36] Impact on patient-reported outcomes [2,12,16,21,26]…”

“…Perceived priority of the problem Public perception of disease burden, disease risk or severity [15,34,35] Acceptability Acceptability in general [2,4,6,14,15,24,26,27,[34][35][36] Acceptability of cost and financial outcomes [2,14,25,26,34] Acceptability by beneficiaries Acceptability by beneficiaries: in general [2,6,8,11,15,16,26,35] Comfort, convenience and user experience [2, 11, 12, 14, 15, 20, 24-26, 31, 33, 35] Acceptability by those providing intervention Acceptability by those providing intervention [15,16,34,35] Social and cultural acceptability Social and cultural acceptability [2,4,8,9,11,15,18,21,22,25,26,[31][32][33][34]36] Ethical...…”

“…Several reviews have explored the criteria used when applying multi-criteria decision analysis (MCDA) [13,[23][24][25][26][27][28], an"umbrella term to describe a collection of formal approaches which seek to take explicit account of multiple criteria in helping individuals or groups explore decisions that matter" [29]. Other reviews have explored the criteria employed in the context of health technology assessments (HTA), which intend to examine social, economic, organizational and ethical considerations in relation to health technologies in a comprehensive manner [30]; these covered both the criteria to inform decisions about health technologies by national or sub-national HTA institutions [19,[31][32][33], and the criteria used for selecting the technologies or interventions a HTA is to be conducted on [8,34]. In general, reviews have addressed criteria used for making decisions on funding or implementing health interventions or technologies [9,10,22,[35][36][37][38], prioritizing research topics [39][40][41] or coverage decisions [7,12,42,43].…”

The Effects of Health Transformation Plan Implementation on the Performance Indicators of Public Hospitals

“…In order to meet the needs of the community with regard to their mission over time and given the rapid pace of technological change, increased expectations of individuals to use the most recent and best technologies, increased service costs, resource shortages, dominance of the market economy over service providing organizations and its unpleasant effects on the health market as well as issues such as poverty and transition of diseases, the health systems undoubtedly require reforms (1,2). All countries are actually seeking reforms and innovations in their health system in order to achieve a universal access to services, justice, quality, and fair payments in the system (3)(4)(5).…”