Research projects REVISE HTA

Revising theory and methods for priority setting

Health care priority setting is a complex political process, involving a diversity of stakeholders. It is not just a matter of costs and health effects. In order to improve legitimate dicision-making at HTA agencies worldwide, REVISE HTA has developed evidence-informed deliberative processes (EDPs).

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Revising theory and methods for priority setting

Health care priority setting is a complex political process, involving a diversity of stakeholders. It is not just a matter of costs and health effects.
 
REVISE HTA stands for ‘REthinking the Valuation of health Interventions for Health Technology Assessment’, and is a research program at Radboud university medical centre in the Netherlands. We aim to develop theory and methods for priority setting, taking into account the complex political nature of decision-making in health care.

More specifically, we want to support HTA agencies around the world, to improve their processes towards more legitimate decision-making. We have developed evidence-informed deliberative processes (EDPs) for this purpose.
 
EDPs is a generic value assessment framework which HTA agencies can adopt to their own needs. The framework integrates elements from Multi criteria decision analysis (MCDA) and Accountability for Reasonableness (A4R), and is based on stakeholder deliberation on the one hand, and reasoned decision-making through evaluation of the identified values on the other hand.
 
In 2019 we issued our practical guidance on EDPs. The guide takes the current HTA process in a country as the starting point, and offers specific advice on how to move towards EDPs, depending on the level of HTA development in a country.

Project leader

Rob Baltussen PhD

+31 (0)24 361 31 19
contact

Our vision

HTA agencies must manoeuvre between the rapid development of new technologies, and ever-expanding pressures on health budgets on the one hand, and strong stakeholder voices demanding access to these technologies on the other hand.

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Our vision

Priority setting is recognized since long as a value-laden political process, in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Yet, present theory and methods for priority setting do not reflect this, and are typically technocratic in nature. This risks to jeopardize the legitimacy of decisions.
 
We consider legitimacy, or perceived reasonableness of decisions, as the key challenge of priority setting in the coming decades. HTA agencies need to manoeuvre between the rapid development of new technologies, and ever-expanding pressures on health budgets on the one hand, and strong stakeholder voices demanding access to these technologies on the other hand. HTA agencies are increasingly scrutinized on how they make decisions, including their processes and the evidence used.

Guidance for HTA agencies

The use of evidence-informed deliberative processes for HTA agencies.

Our products


Our guides and tools

We've created several products related to the use of EDPs.

  • The practical guide on EDPs is intended to help HTA agencies to improve their processes towards more legitimate decision-making.

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    EDPs: a practical guide for HTA agencies

    The practical guide on EDPs is intended to help HTA agencies to improve their processes towards more legitimate decision-making. It can also be used by staff working in the field of HTA/health policy that are keen to further build HTA processes in their country/region.
     
    The practical guide was published following a survey of member agencies of the International Network of Agencies for Health Technology Assessment (INAHTA) that helped develop the content. The result is a free, accessible document that includes the steps to be taken, taking into account the context, remit and scope and purpose of those wishing to apply EDPs.
     
    For each step, we provide the core elements to be addressed, provide methodological guidance and give selected country/regional examples from HTA agencies around the globe. These examples may serve as inspiration for others, especially those countries/regions/organizations that have not yet a formal HTA agency in place.
     
    The guide can be downloaded here.
     
    We would be very glad to hear from you when you have used (parts of) the guide. Please send us your experiences!

     
    For more information please contact Prof. Dr. Rob Baltussen.

  • The use of EDPs for universal health coverage


  • Checklist for stakeholder participation for HTA agencies


Our practical applications

We've created several examples of practical application of EDPs.

  • We have identified the role of health system constraints in the economic evaluation of HIV/AIDS control, and provide recommendations on how to take these into account in future analysis.

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    Incorporating health system constraints in HIV control


  • Implementation of EDPs in HIV control in Indonesia



Our publications sorted on date


Project members