Rob Baltussen1, Kevin Marsh2, Praveen Thokala3, Vakaramoko Diaby4, Hector Castro5, Irina Cleemput6, Martina Garau7, Georgi Iskrov8, Alireza Olyaeemanesh9, Andrew Mirelman10, Mohammedreza Mobinizadeh9, Alec Morton11, Michele Tringali12, Janine van Til13, Joice Valentim14, Monika Wagner15, Sitaporn Youngkong16, Vladimir Zah17, Agnes Toll18, Maarten Jansen18, Leon Bijlmakers18, Wija Oortwijn18, Henk Broekhuizen18. 1. Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: rob.baltussen@radboudumc.nl. 2. Evidera, London, England, UK. 3. University of Sheffield, Sheffield, England, UK. 4. Florida Agricultural and Mechanical University, Tallahassee, FL, USA. 5. Management Sciences for Health, Arlington, VA, USA. 6. Belgian Health Care Knowledge Centre, Brussels, Belgium. 7. Office of Health Economics, London, England, UK. 8. Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Rare Diseases, Plovdiv, Bulgaria. 9. Tehran University of Medical Sciences, Tehran, Iran. 10. University of York, York, England, UK. 11. University of Strathclyde, Glasgow, Scotland. 12. Lombardia Regional Health Directorate, Milan, Italy. 13. University of Twente, Enschede, The Netherlands. 14. Roche, Basel, Switzerland. 15. LASER Analytica, Montreal, Canada. 16. Mahidol University, Bangkok, Thailand. 17. ZRx Outcomes Research Inc, Mississauga, Canada. 18. Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
OBJECTIVE: Recent years have witnessed an increased interest in the use of multicriteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting healthcare priorities. However, its implementation to date has been criticized for being "entirely mechanistic," ignoring opportunity costs, and not following best practice guidelines. This article provides guidance on the use of MCDA in this context. METHODS: The present study was based on a systematic review and consensus development. We developed a typology of MCDA studies and good implementation practice. We reviewed 36 studies over the period 1990 to 2018 on their compliance with good practice and developed recommendations. We reached consensus among authors over the course of several review rounds. RESULTS: We identified 3 MCDA study types: qualitative MCDA, quantitative MCDA, and MCDA with decision rules. The types perform differently in terms of quality, consistency, and transparency of recommendations on healthcare priorities. We advise HTA agencies to always include a deliberative component. Agencies should, at a minimum, undertake qualitative MCDA. The use of quantitative MCDA has additional benefits but also poses design challenges. MCDA with decision rules, used by HTA agencies in The Netherlands and the United Kingdom and typically referred to as structured deliberation, has the potential to further improve the formulation of recommendations but has not yet been subjected to broad experimentation and evaluation. CONCLUSION: MCDA holds large potential to support HTA agencies in setting healthcare priorities, but its implementation needs to be improved.
OBJECTIVE: Recent years have witnessed an increased interest in the use of multicriteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting healthcare priorities. However, its implementation to date has been criticized for being "entirely mechanistic," ignoring opportunity costs, and not following best practice guidelines. This article provides guidance on the use of MCDA in this context. METHODS: The present study was based on a systematic review and consensus development. We developed a typology of MCDA studies and good implementation practice. We reviewed 36 studies over the period 1990 to 2018 on their compliance with good practice and developed recommendations. We reached consensus among authors over the course of several review rounds. RESULTS: We identified 3 MCDA study types: qualitative MCDA, quantitative MCDA, and MCDA with decision rules. The types perform differently in terms of quality, consistency, and transparency of recommendations on healthcare priorities. We advise HTA agencies to always include a deliberative component. Agencies should, at a minimum, undertake qualitative MCDA. The use of quantitative MCDA has additional benefits but also poses design challenges. MCDA with decision rules, used by HTA agencies in The Netherlands and the United Kingdom and typically referred to as structured deliberation, has the potential to further improve the formulation of recommendations but has not yet been subjected to broad experimentation and evaluation. CONCLUSION: MCDA holds large potential to support HTA agencies in setting healthcare priorities, but its implementation needs to be improved.
Authors: Katherine T Lofgren; David A Watkins; Solomon T Memirie; Joshua A Salomon; Stéphane Verguet Journal: Health Econ Date: 2021-10-08 Impact factor: 2.395
Authors: Siobhan Botwright; Anna-Lea Kahn; Raymond Hutubessy; Patrick Lydon; Joseph Biey; Abdoul Karim Sidibe; Ibrahima Diarra; Mardiati Nadjib; Auliya A Suwantika; Ery Setiawan; Rachel Archer; Debra Kristensen; Marion Menozzi-Arnaud; Ado Mpia Bwaka; Jason M Mwenda; Birgitte K Giersing Journal: Vaccine X Date: 2020-10-06