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Title: Multicriteria Decision Analysis to Support Health Technology Assessment Agencies: Benefits, Limitations, and the Way Forward
Authors: Rob Baltussen
Kevin Marsh
Praveen Thokala
Vakaramoko Diaby
Hector Castro
Irina Cleemput
Martina Garau
Georgi Iskrov
Alireza Olyaeemanesh
Andrew Mirelman
Mohammedreza Mobinizadeh
Alec Morton
Michele Tringali
Janine van Til
Joice Valentim
Monika Wagner
Sitaporn Youngkong
Vladimir Zah
Agnes Toll
Maarten Jansen
Leon Bijlmakers
Wija Oortwijn
Henk Broekhuizen
Evidera, United Kingdom
Belgian Health Care Knowledge Centre
Medical University of Plovdiv
Tehran University of Medical Sciences
Florida Agricultural and Mechanical University
University of Strathclyde
University of Twente
University of York
Mahidol University
F. Hoffmann-La Roche AG
Management Sciences for Health
Radboud University Nijmegen Medical Centre
University of Sheffield
Office of Health Economics
LASER Analytica
ZRx Outcomes Research Inc
Institute for Rare Diseases
Regione Lombardia
Keywords: Medicine
Issue Date: 1-Nov-2019
Citation: Value in Health. Vol.22, No.11 (2019), 1283-1288
Abstract: © 2019 ISPOR–The Professional Society for Health Economics and Outcomes Research Objective: Recent years have witnessed an increased interest in the use of multicriteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting healthcare priorities. However, its implementation to date has been criticized for being “entirely mechanistic,” ignoring opportunity costs, and not following best practice guidelines. This article provides guidance on the use of MCDA in this context. Methods: The present study was based on a systematic review and consensus development. We developed a typology of MCDA studies and good implementation practice. We reviewed 36 studies over the period 1990 to 2018 on their compliance with good practice and developed recommendations. We reached consensus among authors over the course of several review rounds. Results: We identified 3 MCDA study types: qualitative MCDA, quantitative MCDA, and MCDA with decision rules. The types perform differently in terms of quality, consistency, and transparency of recommendations on healthcare priorities. We advise HTA agencies to always include a deliberative component. Agencies should, at a minimum, undertake qualitative MCDA. The use of quantitative MCDA has additional benefits but also poses design challenges. MCDA with decision rules, used by HTA agencies in The Netherlands and the United Kingdom and typically referred to as structured deliberation, has the potential to further improve the formulation of recommendations but has not yet been subjected to broad experimentation and evaluation. Conclusion: MCDA holds large potential to support HTA agencies in setting healthcare priorities, but its implementation needs to be improved.
ISSN: 15244733
Appears in Collections:Scopus 2019

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