Best-worst scaling to assess the most important barriers and facilitators for the use of health technology assessment in Austria

Feig, Chiara; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia M. A. A.; Simon, Judit; Mayer, Susanne

doi:10.1080/14737167.2017.1375407

Cited by 12 publications

(15 citation statements)

References 31 publications

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“…It seems that rather the combination with other system characteristics that are inherent in the Austrian system such as fragmentation of funding, governance, and service provision play an important role. Not least, lack of transparency in the decision-making culture has been described as being a core barrier to the inclusion of (cost)-effectiveness evidence into the decision-making processes [24, 36]. For example, resource allocation decisions are often passed on to the level of the clinicians rather than addressing them at the macro-political level (especially in the inpatient sector [37]), which prevents the use of economic evaluation.…”

Section: Discussionmentioning

confidence: 99%

The status of health economic evaluation within decision making in Austria

Zechmeister‐Koss

Stanak

Wolf

2019

Wien Med Wochenschr

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Summary Background Given limited resources compared to the demand for them, spending resources efficiently is important. Key methods applied for supporting efficient resource allocation are health economic evaluations. Methods Based on secondary literature, we analyze international challenges for using two types of economic evaluations—cost-effectiveness analysis and cost-utility analysis—in reimbursement decisions and reflect on them for the Austrian case. Results The main challenges with the application of economic evaluations are related to the methods, the decision-making culture, and the respective system. The challenges also apply to the Austrian Bismarck system, where almost no formal requirements for using economic evaluations exist, except on a case-by-case basis. Resource allocation in Austria hence occurs, for the most part, implicitly. Conclusion One way forward towards more explicit efficiency considerations may be to consider more descriptive study types and foster capacity building, standardization of methods and presentation of results, and a mandatory detailed guideline.

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Section: Discussionmentioning

confidence: 99%

The status of health economic evaluation within decision making in Austria

Zechmeister‐Koss

Stanak

Wolf

2019

Wien Med Wochenschr

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“…As a result, COI studies are an important type of health economic analysis aiming to support health policy and financing decision-making processes [ 2 ]. Over the past decade, health technology assessment has been implemented in most Central and Eastern European (CEE) countries, which, in turn, necessitates reliable, local country-specific COI studies [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Cost-of-illness studies in nine Central and Eastern European countries

et al. 2019

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Background To date, a multi-country review evaluating the cost-of-illness (COI) studies from the Central and Eastern European (CEE) region has not yet been published. Our main objective was to provide a general description about published COI studies from CEE. Methods A systematic search was performed between 1 January 2006 and 1 June 2017 in Medline, EMBASE, The Cochrane Library, CINAHL, and Web of Science to identify all relevant COI studies from nine CEE countries. COI studies reporting costs without any restrictions by age, co-morbidities, or treatment were included. Methodology, publication standards, and cost results were analysed. Results We identified 58 studies providing 83 country-specific COI results: Austria ( n = 9), Bulgaria ( n = 16), Croatia ( n = 3), the Czech Republic ( n = 10), Hungary ( n = 24), Poland ( n = 11), Romania ( n = 3), Slovakia ( n = 3), and Slovenia ( n = 4). Endocrine, nutritional, and metabolic diseases (18%), neoplasms (12%), infections (11%), and neurological disorders (11%) were the most frequently studied clinical areas, and multiple sclerosis was the most commonly studied disease. Overall, 57 (98%) of the studies explicitly stated the source of resource use data, 45 (78%) the study perspective, 34 (64%) the costing method, and 24 (58%) reported at least one unit costs. Regardless of methodological differences, a positive relationship was observed between costs of diseases and countries’ per capita GDP. Conclusions Cost-of-illness studies varied considerably in terms of methodology, publication practice, and clinical areas. Due to these heterogeneities, transferability of the COI results is limited across Central and Eastern European countries. Electronic supplementary material The online version of this article (10.1007/s10198-019-01066-x) contains supplementary material, which is available to authorized users.

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“…They grouped the reported facilitators and barriers as factors related to six categories: (i) contact and collaboration; (ii) organization and resources; (iii) research and researcher characteristics; (iv) policymaker characteristics; (v) policy characteristics; and (vi) other 17 . Their categorization was collapsed by Feig et al into (a) decision-maker-related factors consisting of contact, collaboration and policymaker characteristics; (b) context-related factors consisting of organization, resources and policy characteristics; and (c) methodology related factors, consisting of research and researcher characteristics 24 .…”

Section: Introductionmentioning

confidence: 99%

“…Fewer studies exist that identify the relative importance of influences on the use of evidence in health policymaking. To date, the relative importance of known barriers and facilitators to the use of HTA has been investigated in Austria 24 , Colombia 25 , Germany 26 , France 26 , the Netherlands 26,27 , and the United Kingdom 26 . A ranking of relative importance can serve to identify the order in which to address barriers and promote facilitators, with the assumption that any policy change is gradual and incremental.…”

Section: Introductionmentioning

confidence: 99%

The most important facilitators and barriers to the use of Health Technology Assessment in Canada: a best–worst scaling approach

Wranik

Székely

Mayer

et al. 2021

Journal of Medical Economics

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Background: Health Technology Assessment (HTA), which can support public drug reimbursement decisions will play a core function in the planned national Pharmacare program in Canada. To address existing barriers to the use of HTA, these must be ranked in order of priority. The goal of this study was to access the relative importance of known facilitators and barriers to the use of HTA in the context of the Canadian health care system, with attention to differences between regions and stakeholder groups. Methods: We used the best-worst scaling object case approach to elicit a quantitative ranking of a list of 20 facilitators and 22 barriers. A sample of 68 Canadian HTA stakeholders, including members of expert committees, decision/policymakers, researchers/academics, and others participated in the study. Their task was to identify the most important and the least important item in 12 sub-sets of five facilitators and 14 sub-sets of five barriers. Findings: Relative Importance Scores derived via hierarchical Bayes analysis revealed relations, engagement, and contact between stakeholders as most important on both the barrier and facilitator sides. Other top-ranked facilitators included the availably of credible and relevant research. Other top-ranked barriers included inconsistencies in the evidence and limited generalizability. The availability of HTA guidelines did not rank highly on either side. The main limitation of the study was the challenge with reaching the relevant respondents; this was mitigated by involving the national HTA agency in the research. Conclusion: Canadian stakeholders consider the relationships within the HTA network among the most important. Policies should focus on strengthening these relationships. Future research should focus on the connectivity and distribution of knowledge and power within the HTA network.

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Best-worst scaling to assess the most important barriers and facilitators for the use of health technology assessment in Austria

Cited by 12 publications

References 31 publications

The status of health economic evaluation within decision making in Austria

The status of health economic evaluation within decision making in Austria

Cost-of-illness studies in nine Central and Eastern European countries

The most important facilitators and barriers to the use of Health Technology Assessment in Canada: a best–worst scaling approach

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