Abstract
BackgroundMulticriteria Decision Analysis (MCDA), a formal decision support framework, has been growing in popularity recently in the field of health care. MCDA can support pricing and reimbursement decisions on the macro level, which is of great importance especially in countries with more limited resources.ObjectivesThe aim of this systematic review was to facilitate the development of future MCDA frameworks, by proposing a set of criteria focusing on the purchasing decisions of single-source innovative pharmaceuticals in upper middle-income countries.MethodsA systematic literature review was conducted on the decision criteria included in value frameworks (VFs) or MCDA tools. Scopus, Medline, databases of universities, websites of Health Technology Assessment Agencies, and other relevant organizations were included in the search. Double title-abstract screening and double full-text review were conducted, and all extracted data were double-checked. A team of researchers performed the merging and selection process of the extracted criteria.ResultsA total of 1,878 articles entered the title and abstract screening. From these, 341 were eligible to the full-text review, and 36 were included in the final data extraction phase. From these articles 394 criteria were extracted in total. After deduplication and clustering, 26 different criteria were identified. After the merging and selection process, a set of 16 general criteria was proposed.ConclusionBased on the results of the systematic literature review, a pool of 16 criteria was selected. This can serve as a starting point for constructing MCDA frameworks in upper middle-income countries after careful adaptation to the local context.
Highlights
The Need for Complex Value Assessment in Health Technology Assessment (HTA)Resource allocation in health care is a complex process, economic constraints in all countries necessitate a rational priority setting and a transparent decision-making framework (Baltussen and Niessen, 2006)
It has been a generally accepted principle that health care decision‐making should rely on strong scientific evidence (Rudmik and Drummond, 2013), which called the need for a scientifically justified method to evaluate more than one aspect of the decisionmaking problem at once
The systematic literature review covered Scopus and Medline databases. It was extended with a targeted literature review on specific databases of universities (Centre for Reviews and Dissemination (CRD) database; University of York, England; University of British Columbia, Canada) and websites of Health Technology Assessment Agencies (Independent Institute for Quality and Efficiency in Health Care (IQWIG), Germany; Agency for Health Quality and Assessment of Catalonia (AQUAS), Spain; Swedish Agency For Health Technology Assessment and Assessment Of Social Services (SBU), Sweden; National Institute for Health and Care Excellence (NICE), England; Scottish Medicines Consortium (SMC), Scotland; French National Authority for Health (HAS), France; Canadian Agency for Drugs and Technologies in Health (CADTH), Canada)
Summary
Resource allocation in health care is a complex process, economic constraints in all countries necessitate a rational priority setting and a transparent decision-making framework (Baltussen and Niessen, 2006). This need called Health Technology Assessment (HTA) into being, a multidisciplinary field of policy analysis using explicit analytical frameworks, with the main purpose to inform technology-related policymaking in health care (Facey et al, 2006). MCDA can support pricing and reimbursement decisions on the macro level, which is of great importance especially in countries with more limited resources
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