Methodology for constructing scenarios for health policy research: The case of coverage decision-making for drugs for rare diseases in Canada

Abstract

When futures are uncertain and technological developments stand to have large impacts on healthcare systems, scenario studies can be deployed as a tool for policy exploration. We describe the important differences between firm-based and policy-oriented scenarios, and show how to adapt them for health policy. Our approach involves a five-phase process. Background interviews with a diverse group of stakeholders are used to identify focal points and future challenges. Interview data is analyzed to identify the key drivers of future challenges, which are then used to develop a set of scenarios. The scenarios are deployed in a focus group setting with relevant health policy makers and advisors. We illustrate this approach with our scenario study on coverage decision-making for drugs for rare diseases in Canada. Our focus here is on the extension and application of this scenario method and a sharing of our experiences while applying this method. We demonstrate how scenarios can be applied to identify targets of robust health policy strategies that will be of value irrespective how the future unfolds. Our post-focus group questionnaire show that the majority of participants found the scenario focus group useful, and helped them to identify additional challenges regarding drugs for rare diseases.