Criteria for Decision-Making on Drug Financing in Spain: How Do We Measure Them and What Relevance Does Each One Have?

OBJECTIVES: In Spain, the criteria for deciding whether a medicine is included in the basic package financed by the National Health System (NHS) were established in 2006 in the Law on Guarantees and Rational Use of Medicines and Health Products. However, these criteria are not defined in the afore mentioned law, neither is it described how they should be measured. Our aim is to propose, based on the opinion of a broad sample of experts, the measurement instruments around which there is most consensus for measuring each of the criteria listed in the law.

METHODS: We administered a survey to 1040 experts from different stakeholder groups involved in health economics, health technology assessment, and health technology development and commercialization.

RESULTS: The results of our survey, which we managed to get responses to from 90 experts, yield useful results for proposing measurement instruments to support decision making in medicines financing in Spain. They also show broad consensus on several of the aspects consulted, including the need to use an explicit cost-effectiveness threshold in Spain, and for this threshold to be different for different population groups/special situations.

CONCLUSIONS: We believe that there is scope for increasing the levels of transparency of the methodology applied to support medicines funding decisions in Spain. The results provided in this study could provide a solid starting point for a process of developing the criteria listed in the Medicines Act, detailing the measurement instruments used to quantify each of them.