Abstract
The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit.
Highlights
The Swedish national guidelines use cost-effectiveness data as a basis for ranking decisions and Grip et al reported that “health economics is an integrated part of the evidence base in the Swedish guidelines” [1]
This study investigated how a decision-making group used cost-effectiveness data in ranking priority setting decisions in case of Swedish national guidelines for heart diseases, but the results could be applicable to other jurisdictions where health economics is implemented in decision-making
This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit
Summary
The Swedish national guidelines use cost-effectiveness data as a basis for ranking decisions and Grip et al reported that “health economics is an integrated part of the evidence base in the Swedish guidelines” [1]. Empirical research has shown that Cost-Effectiveness Analysis (CEA), by themselves, have had limited impact on decision-makers [2,3]. In Sweden, empirical research has shown that healthcare decision-makers at the local level have not yet accepted the use of cost-effectiveness evidence in their decision-making to the same extent as at the national level concerning pharmaceuticals [6]. This study aimed to investigate how a decision-making group used cost-effectiveness data in ranking priority setting decisions in case of Swedish national guidelines for heart diseases. We investigated the explicit use of cost-effectiveness data in ranking decisions, especially situations where economic arguments impacted the reasoning behind the decisions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International journal of health policy and management
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
