Castro Jaramillo Hector Eduardo, Goetghebeur Mireille, Moreno-Mattar Ornella
T.H. Chan Harvard School of Public Health,Global Health & Population,Bogotá,Colombia.
LASER ANALYTICA,Montreal and School of Public Health,University of Montreal,Montreal,Quebec,Canada.
Int J Technol Assess Health Care. 2016 Jan;32(4):307-314. doi: 10.1017/S0266462316000350. Epub 2016 Oct 3.
In 2012, Colombia experienced an important institutional transformation after the establishment of the Health Technology Assessment Institute (IETS), the disbandment of the Regulatory Commission for Health and the reassignment of reimbursement decision-making powers to the Ministry of Health and Social Protection (MoHSP). These dynamic changes provided the opportunity to test Multi-Criteria Decision Analysis (MCDA) for systematic and more transparent resource-allocation decision-making.
During 2012 and 2013, the MCDA framework Evidence and Value: Impact on Decision Making (EVIDEM) was tested in Colombia. This consisted of a preparatory stage in which the investigators conducted literature searches and produced HTA reports for four interventions of interest, followed by a panel session with decision makers. This method was contrasted with a current approach used in Colombia for updating the publicly financed benefits package (POS), where narrative health technology assessment (HTA) reports are presented alongside comprehensive budget impact analyses (BIAs).
Disease severity, size of population, and efficacy ranked at the top among fifteen preselected relevant criteria. MCDA estimates of technologies of interest ranged between 71 to 90 percent of maximum value. The ranking of technologies was sensitive to the methods used. Participants considered that a two-step approach including an MCDA template, complemented by a detailed BIA would be the best approach to assist decision-making in this context. Participants agreed that systematic priority setting should take place in Colombia.
This work may serve as the basis to the MoHSP on its interest of setting up a systematic and more transparent process for resource-allocation decision-making.
2012年，哥伦比亚在卫生技术评估研究所（IETS）成立、卫生监管委员会解散以及报销决策权重新分配给卫生和社会保障部（MoHSP）之后，经历了一次重要的制度变革。这些动态变化为测试多标准决策分析（MCDA）以进行系统且更透明的资源分配决策提供了机会。
2012年至2013年期间，MCDA框架“证据与价值：对决策的影响”（EVIDEM）在哥伦比亚进行了测试。这包括一个准备阶段，在此阶段研究人员进行文献检索并为四项感兴趣的干预措施撰写卫生技术评估（HTA）报告，随后与决策者举行小组会议。该方法与哥伦比亚目前用于更新公共资助福利包（POS）的方法形成对比，后者在提供叙述性卫生技术评估（HTA）报告的同时还提供全面的预算影响分析（BIA）。
在预先选定的15项相关标准中，疾病严重程度、人口规模和疗效位列前三。对感兴趣技术的MCDA估计值在最大值的71%至90%之间。技术排名对所使用的方法很敏感。参与者认为，包括MCDA模板并辅以详细BIA的两步法是在此背景下协助决策的最佳方法。参与者一致认为哥伦比亚应进行系统的优先级设定。
这项工作可为卫生和社会保障部建立系统且更透明的资源分配决策流程提供依据。
