Health Technology Prioritisation: Which criteria for prioritising new technologies, and what are their relative weights?

Abstract

Objectives: To review the criteria and 'other' considerations used internationally for prioritising new health technologies, and to demonstrate a conjoint-analysis methodology for deriving relative weights for the criteria. Methods: We searched the literature for criteria and other considerations used internationally for prioritising new technologies. For a set of criteria related to the 'benefits' from technologies, we used a conjoint-analysis survey with a convenience sample of 74 participants to derive their weights. Results: Covering 11 countries and the US state of Oregon, we distinguished three main groups of criteria: (a) Need, appropriateness and clinical benefits; (b) Efficiency (including cost-effectiveness); and (c) Equality, solidarity and other ethical or social values. For several countries, the quality of the clinical and economic evidence and factors related to strategic issues and procedural justice respectively are also considered. The criteria in the conjoint-analysis survey and their derived weights are: 'Lives saved' = 0.343, 'Life-prolongation benefits' = 0.243, 'Quality-of-life gains' = 0.217, a criterion representing the availability of alternative treatments = 0.107, and 'Other important social / ethical benefits' = 0.087. Conclusions: The criteria represented a pluralistic combination of needs-based, maximising and egalitarian principles, and we demonstrated a methodology for deriving their weights based on a conjoint-analysis survey.