Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiv
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METHODOLOGY
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Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis Ole F Norheim1*, Rob Baltussen2, Mira Johri3, Dan Chisholm4, Erik Nord5, DanW Brock6, Per Carlsson7, Richard Cookson8, Norman Daniels9, Marion Danis10, Marc Fleurbaey11, Kjell A Johansson1, Lydia Kapiriri12, Peter Littlejohns13, Thomas Mbeeli14, Krishna D Rao15, Tessa Tan-Torres Edejer3 and Dan Wikler9
Abstract This Guidance for Priority Setting in Health Care (GPS-Health), initiated by the World Health Organization, offers a comprehensive map of equity criteria that are relevant to health care priority setting and should be considered in addition to cost-effectiveness analysis. The guidance, in the form of a checklist, is especially targeted at decision makers who set priorities at national and sub-national levels, and those who interpret findings from cost-effectiveness analysis. It is also targeted at researchers conducting cost-effectiveness analysis to improve reporting of their results in the light of these other criteria. The guidance was develop through a series of expert consultation meetings and involved three steps: i) methods and normative concepts were identified through a systematic review; ii) the review findings were critically assessed in the expert consultation meetings which resulted in a draft checklist of normative criteria; iii) the checklist was validated though an extensive hearing process with input from a range of relevant stakeholders. The GPS-Health incorporates criteria related to the disease an intervention targets (severity of disease, capacity to benefit, and past health loss); characteristics of social groups an intervention targets (socioeconomic status, area of living, gender; race, ethnicity, religion and sexual orientation); and non-health consequences of an intervention (financial protection, economic productivity, and care for others). Keywords: Priority setting, Resource allocation, Cost-effectiveness, Equity, Population health
Introduction Priority setting of health interventions should seek to achieve health system goals, broadly defined as maximization of health, reduction of inequities in health, and financial protection against the costs of ill health [1,2]. Present methods for priority setting are poorly adapted to address the full range of health system objectives. The main approach to establishing health priority setting, cost-effectiveness analysis, addresses only the first objective of maximising health [3-12]. How governments and other responsible authorities balance health maximization with equity and financial protection has far-reaching implications for what health priorities are agreed and pursued [13]. Three is * Correspondence: [email protected] 1 Department of Global Public Health and Primary Care, University of Bergen, PB 7800, 5020 Bergen, Norway Full list of author information is available at the end of the article
therefore urgent need for a more explicit recognition of these additional c
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