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의약품 급여 결정과 다기준의사결정(Multiple Criteria Decision Analysis) 활용에 대한 고찰

Review of the Relevance to Adopting a Multiple Criteria Decision Analysis for Drug Reimbursement Decision Making

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초록

The aim of this study is to consider the relevance to adopting a multiple criteria decision analysis (MCDA) for drug reimbursement decision making from both theoretical and practical perspectives. The study depends on the reviews on selected papers, legal documents and reimbursement assessment review reports. MCDA approach is one of the complementary value matrices along with ‘broadened cost-utility evaluation’ and ‘weighted incremental cost effectiveness ratios (ICERs)’ to overcome the limitation of economic evaluation method; that lacks consideration of a variety of health-related val- ues. Besides MCDA approach, there are other value matrices beyond a criterion of ‘cost-effectiveness’ already in place. The committees have recommended listing of some drugs on the basis of health-re- lated values such as ‘disease severity’, ‘unmet need’, ‘equity’, ‘budget impact’, and ‘high clinical need’ de- spite uncertainties or unacceptability of ICERs. Also MCDA has many theoretical and methodological limitations. It is more relevant to develop the existing value matrix and to improve deliberation pro- cess than to adopt MCDA approach newly.

Abstract

The aim of this study is to consider the relevance to adopting a multiple criteria decision analysis (MCDA) for drug reimbursement decision making from both theoretical and practical perspectives. The study depends on the reviews on selected papers, legal documents and reimbursement assessment review reports. MCDA approach is one of the complementary value matrices along with ‘broadened cost-utility evaluation’ and ‘weighted incremental cost effectiveness ratios (ICERs)’ to overcome the limitation of economic evaluation method; that lacks consideration of a variety of health-related val- ues. Besides MCDA approach, there are other value matrices beyond a criterion of ‘cost-effectiveness’ already in place. The committees have recommended listing of some drugs on the basis of health-re- lated values such as ‘disease severity’, ‘unmet need’, ‘equity’, ‘budget impact’, and ‘high clinical need’ de- spite uncertainties or unacceptability of ICERs. Also MCDA has many theoretical and methodological limitations. It is more relevant to develop the existing value matrix and to improve deliberation pro- cess than to adopt MCDA approach newly.

참고문헌 (58)

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