Institutionalisation Is a Vital Element for Fairness of Priority Setting in the Package Design if the Target is...

Area of Science:

• Health Policy and Systems Research
• Public Health Priority Setting
• Health Economics

Background:

• Fair priority setting is essential for designing effective health benefits packages (HBPs).
• Existing Evidence-Informed Deliberative Processes (EDPs) provide a practical framework for HBP priority setting.
• The integration and sustainability of EDPs within national health systems remain a challenge.

Purpose of the Study:

• To highlight the critical role of institutionalization in ensuring the fairness and impact of Evidence-Informed Deliberative Processes (EDPs) for health benefits package (HBP) priority setting.
• To propose a framework for the institutionalization of EDPs to achieve broader health system goals like universal health coverage (UHC).

Main Methods:

• Conceptual analysis of fairness in health priority setting.
• Review of practical experiences with EDPs in country-level HBP design.
• Development of a staged approach for institutionalizing EDPs.

Main Results:

• EDPs, while practical, require institutionalization to be fair and impactful.
• Lack of institutionalization risks rendering EDPs ineffective, wasting resources.
• Four key stages for institutionalizing EDPs are proposed: legal framework, governance structure, process stipulation, and capacity building.

Conclusions:

• Institutionalization is a critical component of fairness in health priority setting, ensuring EDPs contribute to universal health coverage.
• A systematic, four-stage approach can guide the formal integration of EDPs into health systems.
• Implementing institutionalized EDPs is vital for the long-term success and sustainability of health benefits package design.