|
Overview of centralized priority setting efforts |
|
| Country |
Principles, guidelines, recommendations |
| Year |
|
| Process |
|
|
|
|
| Norway |
Priority principles: |
| 1987/1997 Lønning Committee I and II |
• Severity |
| • Potential effect |
|
| • Cost-effectiveness |
|
| Priority groups based on severity (and later funding): |
|
| • Fundamental |
|
| • Supplementary |
|
| • Low priority |
|
| • No public funding |
|
|
|
|
| The Netherlands |
Sieves/filters to determine basic package of services: |
| 1992/1995 Dutch Committee on Choices in Health Care (Dunning Committee) |
• Is care necessary? |
| • Is care efficient? |
|
| • Is care effective? |
|
| • Can care be left up to individual responsibility? |
|
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|
|
| Sweden |
Ethical platform principles: |
| 1993/1995 Commission of Parliament members and experts |
• Human dignity |
| • Need and solidarity |
|
| • Cost-efficiency |
|
| Political/administrative and clinical priority groups: |
|
| • Life-threatening acute diseases, severe chronic diseases and palliative terminal care |
|
| • Prevention and habilitation/rehabilitation |
|
| • Less severe acute diseases |
|
| • Borderline cases |
|
| • Care for reasons other than disease |
|
|
|
|
| Denmark |
Core values: |
| 1997 Danish Council of Ethics |
• Equal human worth |
| • Solidarity |
|
| • Security and safety |
|
| • Freedom and self-determination |
|
| General goal, framed in terms of "opportunity for self-expression...irrespective of social background and economic ability" |
|
| Partial goals: |
|
| • Social and geographical equity |
|
| • Quality |
|
| • Cost-effectiveness |
|
| • Democracy and consumer influence |
|
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|
| Israel |
Criteria for prioritization of recommended technologies: |
| 1995 Medical Technology Forum and National Advisory Committee, In response to new National Health Insurance Law |
• Life-saving technology with full recovery |
| • Potential to prevent mortality or morbidity |
|
| • Number of patients to benefit |
|
| • Financial burden on society and the patient |
|
| • New technology for diseases with no alternative treatments available |
|
| • Brings increase in longevity and quality of life |
|
| • Benefits of reducing morbidity vs. improving quality of life |
|
| • Net gain is higher than short- or long-term cost |
|
| • Funding of efficacious treatment than is expensive to the individual, but of reasonable cost to society |
|
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|
|
| New Zealand |
Set out principles to guide priority setting decisions: |
| Yearly, beginning in 1993 Core Services Committee/National Health Committee |
• Effectiveness |
| • Efficiency |
|
| • Equity |
|
| • Acceptability |
|
| 'Consensus conferences' for specialized services; |
|
| Recommend core services for given year |
|
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|
| Oregon (US) |
Developed Quality of Well-Being Scale; |
| Beginning in 1989 Health Services Commission |
Used scale to establish cost-effectiveness rankings; |
| Revised rankings after public backlash; |
|
| Continued to use ranked list of condition-treatment pairs |
|
| Recently more emphasis on evidence base for recommendations |
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| UK |
Appraisal of new health technologies; |
| Ongoing, beginning in 1999 National Institute for Clinical Excellence (NICE) |
Development of clinical guidelines; |
| Explicit use of cost-effectiveness evaluations |
|
| Appeal possible on narrow grounds |
|
Sabik and Lie International Journal for Equity in Health 2008 7:4 doi:10.1186/1475-9276-7-4 |
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