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[GRADE: Evidence to Decision (EtD) framework for coverage decisions].

Martina Lietz1, Konstanze Angelescu1, Martina Markes1

  • 1Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln, Deutschland.

Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen
|May 27, 2020
PubMed
Summary
This summary is machine-generated.

The GRADE Evidence to Decision (EtD) framework offers a systematic approach for health coverage decisions. It ensures key criteria are considered, leading to transparent and evidence-based decisions on technology and service reimbursement.

Keywords:
Coverage decisionsErstattungsentscheidungenGRADE

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Area of Science:

  • Health economics
  • Health policy
  • Decision analysis

Background:

  • Coverage decisions by payers are complex and require systematic approaches.
  • The DECIDE project, a GRADE working group initiative, developed Evidence to Decision (EtD) frameworks for various decisions, including coverage.

Purpose of the Study:

  • To present the GRADE Evidence to Decision (EtD) framework tailored for health coverage decisions.
  • To outline a systematic and transparent method for determining coverage for health technologies and services.

Main Methods:

  • An iterative development process involving brainstorming, stakeholder consultation, and user/pilot testing.
  • Adaptation of existing GRADE EtD frameworks for the specific context of coverage decisions.

Main Results:

  • The EtD framework for coverage decisions involves question formulation, assessment using 12 criteria, and conclusions.
  • Criteria for coverage decisions are similar to clinical recommendations but differ in decision-making processes and accountability.
  • Cost-effectiveness is important but not always decisive; recommendations can be conditional (subgroups, research, restrictions).

Conclusions:

  • The EtD framework provides a systematic and transparent method for making health coverage decisions.
  • It facilitates informed judgments by ensuring consideration of key criteria and the best available evidence.