Methodological approaches and use of multiple criteria decision analysis for implementation of National Drug Policy in Ukraine

Authors

DOI:

https://doi.org/10.24959/uekj.19.9

Keywords:

multiple criteria decision analysis, health technology assessment, criteria, medicines

Abstract

In many developed countries, the needs of the population in health protection technology exceeds government financing of health care system. Actually, there are no common models for funding priorities in health care system. To remain a major fields for financing is a serious task for health experts all over the world.

Aim. To develop an algorithm, methodological approaches and stages of multiple criteria decision analysis (MCDA) in Ukraine; to systematize and substantiate the criteria selection, criteria weights and their calculation on the example of innovative medicines in the treatment of oncology and orphan diseases for the efficient use of health care resources in the implementation of the State strategy of National Drug Policy for the period up to 2025.

Results. In this paper we used method of systematization, that in practice of developed countries for health technology assessment (HTA) MCDA started to be implemented in practice, in particular by HTA agencies. The main core clusters of criteria that are basis for use in MCDA models in Ukraine are substantiated and proposed: 1) therapeutic effect and safety; 2) economics; 3) social and ethical factors; 4) disease description, acknowledging that MCDA models should always be adapted to the decision problem and the local settings (epidemiological, statistical data and needs of the national health system). The algorithm, stages and human capital for MCDA inUkraine were considered and systematized based on the data of ISPOR and LSE guidelines: problem structuring, development of the local MCDA model, evaluation, validation, report and elaboration of an action plan on the example of oncology and orphan diseases. We have analysed criteria weights for selection of medicines for the treatment of oncology and orphan diseases based on case studies with experts who are decision makers on medicines procurement. The findings indicate the presence of different value judgements of the importance of criteria in case studies using specially designed questionnaires. The results were processed using the Microsoft Excel software package. It has been established that the two criteria – therapeutic effect and costs were of the highest importance for experts involved in decision-making in financing and the innovation is less relevant in determining procurement priorities.

Conclusions. The MCDA for medical insurance widely used by HTA the agencies worldwide was outlined in our article. Results of the case studies conducted in Ukraine showed that MCDA is an effective and promising tool for scientifically substantiated, transparent decision-making on reimbursement, drug program financing, insurance provision, in particular innovative high-priced medicines with the purpose of rational allocation of resources for pharmaceutical assistance to the population in accordance with the objectives of the National Drug Policy implementation for the period up to 2025.

Author Biography

O. B. Piniazhko, Danylo Halytsky Lviv National Medical University

 

References

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Published

2019-03-01

Issue

Section

Marketing, logistics, pharmacoeconomic research