Political Economy of Priority-Setting and Health Technology Assessment

Many health improving interventions in low- and middle-income countries (LMICs) are extremely good value for money; and Health Technology Assessment (HTA) is an evidence-informed approach for identifying and choosing among those interventions. So why has it often proven difficult to obtain political backing for highly cost-effective interventions such as vaccinations, treatments against diarrhoeal disease in children and preventive policies such as access to clean water or tobacco taxation and for HTA in general?

iDSI is exploring economic, political and legal theories, drawing from and documenting countries’ real experiences of introducing HTA. We hope to shed light on why decision-makers may behave in the way they do; even if this implies departing from what might most benefit the population and in turn offer useful lessons to countries embarking on the journey to embed HTA into their institutional mechanisms.

Scoping and needs assessment

Hernandez-Villafuerte, K., Li, R., Towse, A. and Chalkidou, K. (2015) International Decision Support Initiative (iDSI): Mapping of priority-setting in health in 17 low and middle countries across Asia, Latin America, and Africa. Occasional Paper. April 2015.

See also: Li. R., Hernandez-Villafuerte, K., Towse, A., Vlad, I. and Chalkidou, K. (2016) Mapping Priority Setting in Health in 17 Countries Across Asia, Latin America, and sub-Saharan Africa, Health Systems & Reform, 2:1, 71-83, DOI: 10.1080/23288604.2015.1123338

Amanda Glassman, Kalipso Chalkidou and chairs (2012) Priority-Setting in Health: Building Institutions for Smarter Public Spending, see also Priority-Setting Institutions for Global Health.

Political economy of priority-setting

Chapter 1 p30 Defining the Rules of the Game: Good Governance Principles for the Design and Revision of the Health Benefits Package (Ursula Giedion and Javier Guzmán)

Chapter 12 p277 Priority-Setting as Politics: A Political Economy Framework for Analyzing Health Benefits Package Decisions (Jesse B. Bump and Angela Y. Chang) in Amanda Glassman, Ursula Giedion and Peter C. Smith (eds) What’s In, What’s Out: Designing Benefits for Universal Health Coverage.

Katharina Hauck and Peter C Smith The Politics of Priority Setting in Health: A Political Economy Perspective [version 1; not peer reviewed].

Katharina Hauck, Ranjeeta Thomas & Peter C Smith (2016) Departures from Cost-Effectiveness Recommendations: The Impact of Health System Constraints on Priority Setting, Health Systems & Reform, 2:1, 61-70.

Ioana Vlad, Justin Parkhurst (2016) Political factors influencing the establishment of priority-setting bodies. Presented at Prince Mahidol Award Conference, Bangkok, p25.

Priority-setting and courts of law

Chapter 14 p327 The Right to Health and the Health Benefits Package: Accounting for a Legal Right to Health When Designing a HBP (Rebecca Dittrich, Leonardo Cubillos, Lawrence Gostin, Kalipso Chalkidou and Ryan Li) in Amanda Glassman, Ursula Giedion and Peter C Smith (eds) What’s In, What’s Out: Designing Benefits for Universal Health Coverage. See also Dittrich R. Healthcare priority setting in the courts: A reflection on decision-making when healthcare priority setting is brought to court [version 1; not peer reviewed].

Preconditions and developmental milestones of HTA institutionalisation

Chootipongchaivat S, Tritasavit N, Luz A et al. Conducive factors to the development of Health Technology Assessment in Asia [version 1; not peer reviewed].

Culyer A, Podhisita C and Santatiwongchai B. A Star In The East: History of HITAP [version 1; not peer reviewed].

HTAsiaLink newsletter 9th issue: Building HTA: The Road to Organizational Effectiveness and Efficiency

Downey LE, Mehndiratta A, Grover A, et al. Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India BMJ Global Health 2017;2:e000259.

Tantivess S, Chalkidou K, Tritasavit N and Teerawattananon Y. Health Technology Assessment capacity development in low- and middle-income countries: Experiences from the international units of HITAP and NICE [version 1; referees: 2 approved].

Dittrich R and Asirifi E. Adopting Health Technology Assessment. A report on the socio-cultural, political, and legal influences on health technology assessment adoption. Four case studies: England and Wales, Japan, Poland & Thailand. Working Paper. [version 1; not peer reviewed].

Building capacity to generate, use and broker evidence

Lloyd R, Newbatt E and Jackson A. How to institutionalise evidence-informed priority setting. Rapid Literature Review for the International Decision Support Initiative (iDSI) [version 1; not peer reviewed].

Lavis, J (2016) Supporting evidence-informed priority-setting. Report prepared for the International Decision Support Initiative (iDSI). See also: Ryan Li, Enhancing knowledge transfer and exchange: Reflections from the Seattle workshop on evidence-informed policymaking [version 1; not peer reviewed].

Li R, Ruiz F, Culyer AJ et al. Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research [version 1; referees: 2 approved].

Priority-setting of global development partners

Y-Ling Chi, Jesse B Bump; Resource allocation processes at multilateral organizations working in global health, Health Policy and Planning, Volume 33, Issue suppl_1, 1 February 2018, Pages i4–i13.