HTA and MCDA solely or combined? The case of priority-setting in Colombia

Abstract

BackgroundAll healthcare systems face problems of justice and efficiency related to setting priorities for allocating limited financial resources. Therefore, explicit decision-making in healthcare depicted as a continuum from evidence generation to deliberation and communication of the decision made, needs to be transparent and fair. Nevertheless, priority-setting in many parts of the world remains being implicit and ad-hoc process. Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as policy tools to assist informed decision-making. Both, MCDA and HTA have pros and cons.Main bodyColombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute in 2012. This paper briefly presents the current challenges of the Colombian health system, the general features of the new health sector reform, the main characteristics of HTA in Colombia and the potential benefits and caveats of incorporating MCDA approaches into the decision-making process.ConclusionStructured and objective consideration of the factors that are both measurable and value-based in an open and transparent manner may be feasible through combining HTA and MCDA in contexts like Colombia. Further testing and validation of HTA and MCDA solely or combined in LMICs are needed to advance these approaches into healthcare decision-making worldwide.

Application of Multi-Criteria Decision Analysis (MCDA) to Prioritize Real-World Evidence Studies for Health Technology Management: Outcomes and Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration

“…MCDA is being considered and, in many cases, implemented within international HTA agencies as a mechanism to support transparent, robust, and equitable decision-making as well as in various other decision contexts (e.g., priority setting, clinical decision-making, etc.) [10,15,[19][20][21][22][23]. In Canada, value assessment frameworks have been developed to assess the value of oncology therapeutics being funded through public drug programs [24,25].…”

Correction to: HTA and MCDA solely or combined? The case of priority-setting in Colombia

“…Following publication of this supplement article [ 1 ], the authors reported an error in the citation provided in the caption of Fig. 1.…”

HTA roadmap for Egypt : Health Technology Assessment Roadmap and Implementation Action Plan for Egypt

“…• HTA lacks the ability to incorporate societal values into the decision-making process. HTA tends to slow down decisions due to restrictions generated by the appraisal, which in addition to negative reimbursement decisions hinder patients' access to health technologies, especially noted in cases of orphan drugs (Adkins, 2017;Aggarwal, 2014;Castro, 2018;Kido, 2019;Van Wilder, 2019;Yazdizadeh, 2018). • Negative reimbursement decision led to a strong resistance from clinicians (Schuller, 2017)…”

“…It generates cost saving through informing reimbursement and disinvestment decisions, which in the long-term improves technical, and allocative efficiency, as well as strategic pricing. HTA can contribute to budget control to ensure fiscal sustainability (Al-Aqeel, 2018;Angelis, 2018;Beletsi, 2018;Borges, 2018;Callea, 2017;Castro, 2018;Dabak, 2019;Dang, 2016;Epstein, 2020;Gagnon, 2014;Guthrie, 2015;Hailey, 2016;Hasegawa, 2020;Kanavos, 2019;Kido, 2019;Leelahavarong, 2019;Mahlich, 2017;Miquel-Cases, 2017;Nestler-Parr, 2018;Pearce, 2019;Schuller, 2017;Schumacher, 2013;Surgey, 2020;Tanvejsilp, 2019;Van Wilder, 2019;Vostalová, 2017;Yazdizadeh, 2018). • HTA improves pharmaceutical pricing, specially it ensures better value for money of orphan drugs (Kogushi, 2020;Mägi, 2018;Nestler-Parr, 2018;Roza, 2019;Vo, 2018).…”

“…Middle Income Countries Literature A total of thirteen middle-income countries (according to the WB classification) were discussed 20 times in 16 of the included papers (Aggarwal, 2014;Beletsi, 2018;Borges, 2018;Castro, 2018;Dabak, 2019;Dang, 2016;Hailey, 2016;Kosherbayeva, 2018;Leelahavarong, 2019;Lopert, 2013;Novaes, 2016;Roza, 2019;Shafie, 2019;Vo, 2018;Yazdizadeh, 2018). Most countries reported that HTA enabled the achievement of better decisions.…”