Methodological approaches and use of multiple criteria decision analysis for implementation of National Drug Policy in Ukraine
DOI:
https://doi.org/10.24959/uekj.19.9Keywords:
multiple criteria decision analysis, health technology assessment, criteria, medicinesAbstract
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.
References
Postanova KMU vid 5 hrudnia 2018 r. № 1022. (2018). Pro zatverdzhennia Derzhavnoi stratehii realizatsii derzhavnoi polityky zabezpechennia naselennia likarskymy zasobamy na period do 2025 roku. – Available at: https://zakon.rada.gov.ua/laws/show/1022-2018-%D0%BF
Priority medicines for Europe and the world – 2013 update. (2013). WHO. – Available at: http://www.who.int/medicines/areas/priority_medicines/MasterDocJune28_FINAL_Web.pdf
Hill, S., & Kieny, M. P. (2017). Towards access 2030. The Lancet, 389(10067), 341–343. https://doi.org/10.1016/s0140-6736(16)31904-3
Thokala, P., Devlin, N., Marsh, K., Baltussen, R., Boysen, M., Kalo, Z., … Ijzerman, M. (2016). Multiple Criteria Decision Analysis for Health Care Decision Making—An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value in Health, 19(1), 1–13. https://doi.org/10.1016/j.jval.2015.12.003
Marsh, K., IJzerman, M., Thokala, P., Baltussen, R., Boysen, M., Kaló, Z., … Devlin, N. (2016). Multiple Criteria Decision Analysis for Health Care Decision Making—Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force. Value in Health, 19(2), 125–137. https://doi.org/10.1016/j.jval.2015.12.016
Angelis, A., & Kanavos, P. (2016). Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment. PharmacoEconomics, 34(5), 435–446. https://doi.org/10.1007/s40273-015-0370-z
Angelis, A., & Kanavos, P. (2017). Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework. Social Science & Medicine, 188, 137–156. https://doi.org/10.1016/j.socscimed.2017.06.024
Piniazhko, O. B., Zaliska, O. M. (2015). Pharmaceutical Review, 2 (34), 119–124. https://doi.org/10.11603/2312-0967.2015.2.4760
Piniazhko, O. B., Zaliska, O. M. (2017). Farmatsevtychnyi zhurnal, 5-6, 24-31.
Piniazhko, O. B., Zaliska, O. M. (2018). Multykryterialnyi analiz rishen dlia otsinky tekhnolohii okhorony zdorov’ia (likarskykh zasobiv): naukove obgruntuvannia ta praktychne zastosuvannia v Ukraini. Metodychni rekomendatsii. LNMU: 23.
Nemeth, B., & Piniazhko, O. (2016). Mcda Application In Central And Eastern Europe: Selection Of The Most Important Criteria Based On Examples. Value in Health, 19(7), 471. https://doi.org/10.1016/j.jval.2016.09.723
Piniazhko, O., Nemeth, B. (2017). Practical issues of determing weights for criteria to be used in an MCDA framework – based on a case study. Value in Health, 20 (5), A51.
Piniazhko, O., Zalis’ka, O., & Zah, V. (2016). Eliciting Payers Preferences In Central And Eastern Europe: Results Of Mcda Case Study. Value in Health, 19(7), A367. https://doi.org/10.1016/j.jval.2016.09.124
Downloads
Published
Issue
Section
License
Copyright (c) 2019 National University of Pharmacy
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).