OBJECTIVES: to improve decision-making mechanisms in the health technologies assessment (HTA) in Russia to eliminate the subjective aspect in decision-making and optimize healthcare costs.

According to the current legislation in Russia, many criteria are considered when assessing health technologies, however most of them do not have a quantitative assessment that effects on decision-making.

The Multi-Criteria Decision Analysis (MCDA) method of HTA in Russia can help decision-makers assess alternatives based on multiple criteria. For the development of the MCDA methodology, at the first stage, the most important criteria for HTA are determined. The weights of this criteria can be determined using the method of expert assessments: the hierarchy analysis method. All criteria will be matched against each other in pairs. Matrices of paired comparisons are constructed for each expert. For matrices of pairwise comparisons, a vector of weights is calculated. Then this vector is normalized to obtain the desired priority vector. As a result, the factors used for the assessment and their weights will be determined.

An excellent approach was taken to further evaluate the drug. If the effectiveness of two alternative drugs A and B for each of the criteria m is equal to v_m(a) and v_m(b), respectively, we can conclude that drug A should be preferable to drug B if v_m(a) ≥ v_m (b) by all criteria (with strict inequality for at least one criterion).

This approach can lead to incompatibility if the two drugs are very similar; however, it can be argued that this is appropriate for the assessment process, as further discussion may be required to choose between drugs if their efficacy is very similar.

In this way, the MCDA approach can support rather than replace the existing deliberative process, adding consistency and transparency through explicit evaluation and weighting of criteria.