Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward

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 & 3 others Leon Bijlmakers, Wija Oortwijn, Henk Broekhuizen

Research output: Contribution to journalArticle

Abstract

Objective
Recent years have witnessed anincreased interest in the use of multi-criteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting health care priorities. However, its implementation to date has been criticised for being "entirely mechanistic", ignoring opportunity costs and not following best practice guidelines. This paper provides guidance on the use of MCDA in this context.
Study design
Consensus development; Systematic review
Methods We developed a typology of MCDA studies and good implementation practice. We reviewed 37 studies over the period 1990-2018 on their compliance with good practice, and developed recommendations. We reached consensus among authors over the course of several review rounds.
Results
We identified three 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 health care 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 UK and typically referred to as structured deliberation, has the potential to further improve the formulationof recommendations but has not yet been subjected to broad experimentation and evaluation.
LanguageEnglish
Pages1283-1288
Number of pages6
JournalValue in Health
Volume22
Issue number11
Early online date16 Oct 2019
Publication statusE-pub ahead of print - 16 Oct 2019

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Biomedical Technology Assessment
Decision Support Techniques
Health Priorities
Practice Guidelines
Delivery of Health Care
Netherlands
Costs and Cost Analysis

Keywords

  • multi criteria decision analysis
  • priority setting
  • value framework
  • HTA agencies

Cite this

Baltussen, R., Marsh, K., Thokala, P., Diaby, V., Castro, H., Cleemput, I., ... Broekhuizen, H. (2019). Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward. Value in Health, 22(11), 1283-1288.
Baltussen, Rob ; Marsh, Kevin ; Thokala, Praveen ; Diaby, Vakaramoko ; Castro, Hector ; Cleemput, Irina ; Garau, Martina ; Iskrov, Georgi ; Olyaeemanesh, Alireza ; Mirelman, Andrew ; Mobinizadeh, Mohammedreza ; Morton, Alec ; Tringali, Michele ; van Til, Janine ; Valentim, Joice ; Wagner, Monika ; Youngkong, Sitaporn ; Zah, Vladimir ; Toll, Agnes ; Jansen, Maarten ; Bijlmakers, Leon ; Oortwijn, Wija ; Broekhuizen, Henk. / Multicriteria decision analysis to support health technology assessment agencies : benefits, limitations, and the way forward. In: Value in Health. 2019 ; Vol. 22, No. 11. pp. 1283-1288.
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Baltussen, R, Marsh, K, Thokala, P, Diaby, V, Castro, H, Cleemput, I, Garau, M, Iskrov, G, Olyaeemanesh, A, Mirelman, A, Mobinizadeh, M, Morton, A, Tringali, M, van Til, J, Valentim, J, Wagner, M, Youngkong, S, Zah, V, Toll, A, Jansen, M, Bijlmakers, L, Oortwijn, W & Broekhuizen, H 2019, 'Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward' Value in Health, vol. 22, no. 11, pp. 1283-1288.

Multicriteria decision analysis to support health technology assessment agencies : benefits, limitations, and the way forward. / Baltussen, Rob; Marsh, Kevin; Thokala, Praveen; Diaby, Vakaramoko; Castro, Hector; Cleemput, Irina; Garau, Martina; Iskrov, Georgi; Olyaeemanesh, Alireza; Mirelman, Andrew; Mobinizadeh, Mohammedreza; Morton, Alec; Tringali, Michele; van Til, Janine; Valentim, Joice; Wagner, Monika; Youngkong, Sitaporn; Zah, Vladimir; Toll, Agnes; Jansen, Maarten; Bijlmakers, Leon; Oortwijn, Wija; Broekhuizen, Henk.

In: Value in Health, Vol. 22, No. 11, 30.11.2019, p. 1283-1288.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multicriteria decision analysis to support health technology assessment agencies

T2 - Value in Health

AU - Baltussen, Rob

AU - Marsh, Kevin

AU - Thokala, Praveen

AU - Diaby, Vakaramoko

AU - Castro, Hector

AU - Cleemput, Irina

AU - Garau, Martina

AU - Iskrov, Georgi

AU - Olyaeemanesh, Alireza

AU - Mirelman, Andrew

AU - Mobinizadeh, Mohammedreza

AU - Morton, Alec

AU - Tringali, Michele

AU - van Til, Janine

AU - Valentim, Joice

AU - Wagner, Monika

AU - Youngkong, Sitaporn

AU - Zah, Vladimir

AU - Toll, Agnes

AU - Jansen, Maarten

AU - Bijlmakers, Leon

AU - Oortwijn, Wija

AU - Broekhuizen, Henk

PY - 2019/10/16

Y1 - 2019/10/16

N2 - ObjectiveRecent years have witnessed anincreased interest in the use of multi-criteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting health care priorities. However, its implementation to date has been criticised for being "entirely mechanistic", ignoring opportunity costs and not following best practice guidelines. This paper provides guidance on the use of MCDA in this context.Study designConsensus development; Systematic reviewMethods We developed a typology of MCDA studies and good implementation practice. We reviewed 37 studies over the period 1990-2018 on their compliance with good practice, and developed recommendations. We reached consensus among authors over the course of several review rounds.ResultsWe identified three 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 health care 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 UK and typically referred to as structured deliberation, has the potential to further improve the formulationof recommendations but has not yet been subjected to broad experimentation and evaluation.

AB - ObjectiveRecent years have witnessed anincreased interest in the use of multi-criteria decision analysis (MCDA) to support health technology assessment (HTA) agencies for setting health care priorities. However, its implementation to date has been criticised for being "entirely mechanistic", ignoring opportunity costs and not following best practice guidelines. This paper provides guidance on the use of MCDA in this context.Study designConsensus development; Systematic reviewMethods We developed a typology of MCDA studies and good implementation practice. We reviewed 37 studies over the period 1990-2018 on their compliance with good practice, and developed recommendations. We reached consensus among authors over the course of several review rounds.ResultsWe identified three 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 health care 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 UK and typically referred to as structured deliberation, has the potential to further improve the formulationof recommendations but has not yet been subjected to broad experimentation and evaluation.

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KW - priority setting

KW - value framework

KW - HTA agencies

M3 - Article

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SP - 1283

EP - 1288

JO - Value in Health

JF - Value in Health

SN - 1098-3015

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ER -

Baltussen R, Marsh K, Thokala P, Diaby V, Castro H, Cleemput I et al. Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward. Value in Health. 2019 Nov 30;22(11):1283-1288.