期刊
HEALTH POLICY
卷 86, 期 1, 页码 1-9出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.healthpol.2007.09.007
关键词
resource allocation; decision-making; priority setting; drug formulary; pharmaceuticals
Rising pharmaceutical expenditure leads to an increased need for priority setting in medicinal care. The objective of this paper is to review studies that empirically analyse a macro-and meso-level decision-making process for including drugs in and/or excluding drugs from reimbursement lists and drug formularies in industrialized countries. We identified six separate studies analysing a decision-making process as a whole. According to them, the most important groups in decision-making were experts and administrative persons. The decision-makers had an explicitly or implicitly defined set of criteria that were considered in decision-making, with clinical evidence on the benefit and the costs being the main criteria used. However, formal pharmacoeconomic analyses were given a rather small role. The criteria used varied between studies, and also between decisions. The decisions seemed inevitably to be partly value-based in their nature, as the scientific or other exact evidence did not give a firm foundation on which the decisions could be solely based. The majority of the studies concentrated on descriptive analysis on how things are rather than on explicitly analysing how decision-making processes perform against defined principles or goals. To facilitate decision-making by clearly defined principles and methods, more analytic studies on decision-making are especially needed. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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