Development of a Prioritization Framework to Aid Healthcare Funding Decision Making in Health Technology Assessment in Australia: Application of Multicriteria Decision Analysis

IF 4.9 2区 医学 Q1 ECONOMICS Value in Health Pub Date : 2024-11-01 DOI:10.1016/j.jval.2024.07.003
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Abstract

Objectives

This study develops a prioritization framework to aid healthcare funding decision making in health technology assessment (HTA) in Australia using a multiple criteria decision analysis (MCDA) approach.

Methods

MCDA frameworks for HTAs were reviewed through literature survey to identify the initial criteria and levels within each criterion. Key stakeholders and experts were consulted to confirm these criteria and levels. A conjoint analysis using 1000Minds was undertaken with policy makers from the Department of Health to establish ranking criteria and weighting scores. Monte Carlo simulations were used to examine the sensitivity of findings to factors affecting the ranking and weighting scores. The MCDA was then applied to 6 examples of chronic care models or technologies projects to demonstrate the performance of this approach.

Results

Five criteria (clinical efficacy/effectiveness, safety and tolerability, severity of the condition, quality/uncertainty, and direct impact on healthcare costs) were consistently ranked highest by healthcare decision makers. Among the criteria, patient-level health outcomes were considered the most important, followed by social and ethical values. The analyses were robust to inform the uncertainty in the parameter.

Conclusions

This study has developed an MCDA tool that effectively integrates key priorities for HTA reviews, reflecting the values and preferences of healthcare stakeholders in Australia. Although this tool aims to align the assessment process more closely with health benefits, it also highlights the importance of considering other criteria.
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在澳大利亚卫生技术评估 (HTA) 中制定优先次序框架以协助医疗保健资金决策:多标准决策分析的应用。
目的:本研究采用多标准决策分析(MCDA)方法,制定了一个优先次序框架,以帮助澳大利亚医疗卫生技术评估(HTA)中的医疗资金决策:本研究采用多标准决策分析(MCDA)方法,制定了一个优先顺序框架,以帮助澳大利亚医疗卫生技术评估(HTA)中的医疗资金决策:方法:通过文献调查回顾了用于 HTA 的 MCDA 框架,以确定初步标准和每项标准中的等级。咨询了主要利益相关者和专家,以确认这些标准和等级。与卫生部的政策制定者一起使用 1000Minds© 进行联合分析,以确定排序标准和加权分数。使用蒙特卡洛模拟来检查结果对影响排序和加权分数的因素的敏感性。然后将 MCDA 应用于六个慢性病护理模式或技术项目实例,以展示这种方法的性能:结果:医疗决策者始终将五项标准(临床疗效/有效性;安全性和耐受性;病情严重程度;质量/不确定性;对医疗成本的直接影响)排在首位。在这些标准中,患者层面的健康结果被认为是最重要的,其次是社会和伦理价值。分析结果对参数的不确定性很有说服力:本研究开发了一种 MCDA 工具,有效整合了 HTA 评审的关键优先事项,反映了澳大利亚医疗保健利益相关者的价值观和偏好。虽然该工具旨在使评估过程更贴近健康效益,但它也强调了考虑其他标准的重要性。
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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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