Health technology funding decision-making processes around the world: the same, yet different

Area of Science:

• Health Policy and Economics
• Health Technology Assessment
• Public Health Decision-Making

Background:

• Healthcare systems globally grapple with resource allocation, particularly for new health technologies.
• Intensified public scrutiny necessitates understanding and improving health technology funding decisions.
• Decisions on new technologies often create perceived 'winners' and 'losers', increasing public concern.

Purpose of the Study:

• To critically review and compare current health technology funding decision-making processes.
• To analyze processes at national, state/provincial, and regional/institutional levels across 20 countries.
• To identify strengths and weaknesses in existing health technology assessment and funding frameworks.

Main Methods:

• A comprehensive literature search (peer-reviewed and grey) for technology decision-making processes.
• Information extraction by two independent reviewers, followed by qualitative comparative analysis.
• Analysis of organizational websites for evaluations to identify process strengths and weaknesses.

Main Results:

• 21 national, 4 provincial/state, and 6 regional/institutional processes were identified and categorized.
• Processes were grouped into four stages: problem identification, information inputs, decision-making elements, and public accountability.
• While information requirements were substantial, their utilization and incorporation of social values/equity were often unclear.

Conclusions:

• Current health technology funding processes require greater transparency in decision criteria and the use of social values.
• Further research is needed to improve the acceptability and equity of health technology funding decisions.
• Explicating decision criteria and social values is crucial for enhancing public trust in resource allocation.