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Special Report

Multi-criteria decision analysis for health technology assessment in Canada: insights from an expert panel discussion

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Abstract

Multi-criteria decision analysis (MCDA), a decision-making tool, has received increasing attention in recent years, notably in the healthcare field. For Canada, it is unclear whether and how MCDA should be incorporated into the existing health technology assessment (HTA) decision-making process. To facilitate debate on improving HTA decision-making in Canada, a workshop was held in conjunction with the 8th World Congress on Health Economics of the International Health Economics Association in Toronto, Canada in July 2011. The objective of the workshop was to discuss the potential benefits and challenges related to the use of MCDA for HTA decision-making in Canada. This paper summarizes and discusses the recommendations of an expert panel convened at the workshop to discuss opportunities and concerns with reference to the implementation of MCDA in Canada.

Disclaimer

The ideas conveyed and conclusions drawn in this paper do not necessarily represent the position of Amgen Canada.

Acknowledgements

The authors of the current paper are grateful to L Forte and B Bick for their contribution in the organization of the workshop. The authors would also like to thank J Barber and E Campbell, Associate Professors, Economic Social and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, for their insightful comments on earlier versions of the paper.

Financial & competing interests disclosure

Amgen Canada sponsored the IHEA session and proceedings as well as the literature search used by the expert panelists. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues
  • Multi-criteria decision analysis (MCDA) provides an opportunity for healthcare authorities, Canadian provinces in particular, to make decisions that reflect the unique priorities of the residents within their jurisdictions.

  • Potential barriers that oppose resistance to the successful implementation of MCDA in Canada include fragmented decision-making across provinces, political will and methodological challenges toward implementation of an MCDA process.

  • A collaborative approach involving all stakeholders will help establish meaningful decision-making criteria based on ethical considerations.

  • Potential avenues to overcome methodological concerns include the use of variable interdependent parameters analysis to account for the stochastic nature of decision-makers’ preferences and the use of maximum regret to approximate opportunity cost in MCDA modeling.

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