PMD136 - THE FEASIBILITY OF APPLYING THE MULTIPLE CRITERIA DECISION ANALYSIS FOR THE EVALUATION OF MEDICAL DEVICES IN THE CONTEXT OF HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN TURKEY

Abstract

Health technology assessment (HTA), which draws from medical, social and economic studies, has become an integral part of healthcare resource allocation decisions in many countries. Multiple Criteria Decision Analysis (MCDA) has been proposed for use in HTA due to the failure of Cost-Effectiveness Analysis (CEA) capturing all dimensions of the health benefits of medical technologies. The objective of this study, therefore, is to assess the applicability of MCDA in the context of hospital-based HTA (HB-HTA) for the evaluation of medical devices in Turkey. The EU funded AdHopHTA (Adopting Hospital Based Health Technology Assessment) project, conducted a case study at the Ankara Numune Training and Research Hospital in Turkey to examine the dynamics of the decision-making process of hospital managers on the uptake of health technologies. The survey results, based on the interviews with hospital managers, were further analysed for the purpose of this study. The Multi Attribute Value Theory (MAVT) is used as an MCDA technique here. The methodological stages of MAVT are applied to the current economic evaluation part of the HB-HTA processes in Turkey. The survey results demonstrated two needs of hospital managers in the decision-making process: 1) reaching a high level of consensus on the final HTA decision and 2) making a comparative analysis that captures the medical, social and economic benefits of medical devices in a scientific way. This study showed that the methodological stages of MAVT are very similar to the overall processes of HB-HTA in Turkey, with an addition of a formal mathematical approach that considers all relevant criteria transparently with the involvement of various stakeholders. MCDA has the great potential to support the decision-making process of HB-HTA bodies and hospital managers in evaluating the value of medical devices in Turkey, although further discussions and pilots are needed.