PRIORITY SETTING OF NEW MEDICAL INTERVENTIONS IN TAIWAN- A MULTICRITERIA DECISION ANALYSIS
Author(s)
Lin C1, Tsai W2, Shen T3
1I-Shou University, Kaohsiung, Taiwan, 2National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan, 3E-DA Hospital, Kaohsiung, Taiwan
OBJECTIVES: Priority setting in the allocation of new medical interventions is increasingly based on formulated values. Before drafting the new medical service items and fee schedule, the National Health Insurance Act of Taiwan identifies four prioritizing rules -human health, medical ethics, cost-effectiveness, and the finances of the Insurance respectively to compliance with. Our study objectives are to compare the policy makers’ actual value preferences with these four official formulated principles and to guide the Ministry of Health and Welfare in Taiwan in the priority setting of new medical interventions. METHODS: We used a multicriteria decision analytical framework. In total 65 respondents participated in a discrete choice experiment to weigh their relative importance of six selected policy criteria for priority setting. Regression analysis was used to rank order a set of new recently adopted medical interventions on the basis of these criteria and related to weights. RESULTS: Policymakers considered severity of disease, people of middle-age, cost effectiveness as the most important criteria for priority setting of interventions, followed by low budget impact. Signs of coefficients of many beneficiaries and large individual benefits did not have the expected direction. Certain interventions in HIV Ag/Ab test, HLA-B 1502 gene typing, HCV Genotyping Test and orthopedic surgery rank highest. Cochlear implant ranks 12th out of 22 medical interventions. CONCLUSIONS: Policy makers’ values are partially in agreement with principles formulated in National Health Insurance laws. Multi-criteria decision approaches may provide a tool to guide explicit allocation decisions.
Conference/Value in Health Info
2014-09, ISPOR Asia Pacific 2014, Beijing, China
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PHP101
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Coverage with Evidence Development & Adaptive Pathways, Health Care Research
Disease
Multiple Diseases