Priority setting in health care: Lessons from the experiences of eight countries

“There are also problems of ensuring that avenues for public input established on paper are implemented and that input reflects broad and relevant community views [ 52- 55 ].”

“Despite its limitations, CEA is currently the best developed and most used approach to assess whether interventions produce value for money [56-62].”

“NICE explicitly integrates cost in every case of guideline development and technology assessment [44,67].”

“Despite its limitations, CEA is currently the best developed and most used approach to assess whether interventions produce value for money [56-62].”

“In 2001 the NHC began a review that culminated in a 2004 report echoing their earlier recommendation against population-wide PSA screening [53,76,77].”

“While their systems differ, many core allocation issues are the same [13-21].”

“While their systems differ, many core allocation issues are the same [13-21].”

“Instead, in 1999 the National Institute for Clinical Excellence (now the National Institute for Health and Clinical Excellence) (NICE) was established to: 1) appraise new health technologies, 2) develop clinical guidelines, and 3) assess interventional procedures [44,45].”

“While the program of rationing Medicaid services in Oregon was successful in covering a larger population and reducing the number of uninsured, it was extremely controversial and faced a number of political and practical roadblocks along the way [32].”

“Despite its limitations, CEA is currently the best developed and most used approach to assess whether interventions produce value for money [56-62].”

“... in the early 1990's represents the most explicit, as well as one of the most controversial, examples of priority setting in health care in the US. The goal of the program was to extend coverage to all Oregonians below 100% of the federal poverty level (as opposed to 58% FPL, as it was previously) by limiting cover…”

“The Committee takes into account the assessments and recommends whether new technologies should be included in the basic basket, as well as limitations on their use [38].”

“While it can be difficult to realize, public engagement with prioritization issues is necessary to ensure fairness and legitimacy [5,10, 49-51 ] Exactly how this is done can vary.”

“Scarcity raises questions of justice and efficiency: how should limited health care resources be allocated? What health services should be publicly funded? How should indications for particular interventions be defined? [1-6].”

“Despite its limitations, CEA is currently the best developed and most used approach to assess whether interventions produce value for money [56-62].”

“The Oregon process was concerned with incorporating public values from the beginning, and the Oregon Health Services Commission sponsored eleven public hearings, forty-seven town meetings and fielded a telephone survey before the initial rankings were decided [29].”

“Further, the lack of political tension within the Swedish Commission, which included parliamentary representatives of all major parties, was seen by many as a sign that the group avoided controversial issues central to priority setting [23].”

“While it can be difficult to realize, public engagement with prioritization issues is necessary to ensure fairness and legitimacy [5,10,49-51] Exactly how this is done can vary.”

“using beta-interferon for treatment of multiple sclerosis based on cost-effectiveness grounds, for example, caused an outcry from MS groups, and its final recommendation was controversial among the medical and research communities as well [34,65,68-72].”

“In general, governments and planning groups continued to make decisions about coverage based on a host of other factors, including political concerns and media pressure [14,61,73].”

“While the program of rationing Medicaid services in Oregon was successful in covering a larger population and reducing the number of uninsured, it was extremely controversial and faced a number of political and practical roadblocks along the way [32].”

“The second Swedish commission referred to four public surveys, two of which it funded, and held five regional conferences[21,63].”

“using beta-interferon for treatment of multiple sclerosis based on cost-effectiveness grounds, for example, caused an outcry from MS groups, and its final recommendation was controversial among the medical and research communities as well [34,65,68-72].”

“When other countries began convening commissions on priority setting there was a call by some for the UK to follow [19,40-43].”

“Scarcity raises questions of justice and efficiency: how should limited health care resources be allocated? What health services should be publicly funded? How should indications for particular interventions be defined? [1-6].”

“The yearly reevaluation of the health services and discussion of other health care issues by the NHC in New Zealand is the best example of effective review and evaluation [14,41].”

“This can be achieved through different mechanisms, including, for example, group exercises in choosing hypothetical health care packages [3,46-48].”

“There are also problems of ensuring that avenues for public input established on paper are implemented and that input reflects broad and relevant community views [ 52- 55 ].”

“While it can be difficult to realize, public engagement with prioritization issues is necessary to ensure fairness and legitimacy [5,10,49-51] Exactly how this is done can vary.”

“This can be achieved through different mechanisms, including, for example, group exercises in choosing hypothetical health care packages [3,46-48].”

“Scarcity raises questions of justice and efficiency: how should limited health care resources be allocated? What health services should be publicly funded? How should indications for particular interventions be defined? [1-6].”

“Priority setting or rationing in health care continues to be a politically charged topic, but recently its necessity has gained wider recognition [7-11].”

“While their systems differ, many core allocation issues are the same [13-21].”

“This can be achieved through different mechanisms, including, for example, group exercises in choosing hypothetical health care packages [3,46-48].”

“using beta-interferon for treatment of multiple sclerosis based on cost-effectiveness grounds, for example, caused an outcry from MS groups, and its final recommendation was controversial among the medical and research communities as well [34,65,68-72].”

“Thus, as in New Zealand, no explicit process for deciding on the basic basket was undertaken at the time, though it was recognized that a process was needed for updating the basic basket of services [36,37].”

“Explicitly addressing priority setting is necessary to develop fairer methods of allocation for scarce health care resources [7,10,12] and to begin a public dialogue to ensure legitimacy in the process [3,5].”

“using beta-interferon for treatment of multiple sclerosis based on cost-effectiveness grounds, for example, caused an outcry from MS groups, and its final recommendation was controversial among the medical and research communities as well [34,65,68-72].”

“While their systems differ, many core allocation issues are the same [13-21].”

“Explicitly addressing priority setting is necessary to develop fairer methods of allocation for scarce health care resources [7,10,12] and to begin a public dialogue to ensure legitimacy in the process [3,5].”

“While it can be difficult to realize, public engagement with prioritization issues is necessary to ensure fairness and legitimacy [5,10,49-51] Exactly how this is done can vary.”

“Changes in health services after recommendations were issued did not reflect the extensive discussions and proposals put forth by the commissions [73,74].”

“When other countries began convening commissions on priority setting there was a call by some for the UK to follow [19,40-43].”

“using beta-interferon for treatment of multiple sclerosis based on cost-effectiveness grounds, for example, caused an outcry from MS groups, and its final recommendation was controversial among the medical and research communities as well [34,65,68-72].”

“As mental health services tend to prioritise more serious cases [69], by neglecting to physically care for herself, Amy was aiming at being seen as a priority.”