Table 2 Priority setting criteria. Main sources
Domain | Considered criteria | Alternative categorizations / subgroupings |
|---|---|---|
Need for intervention | -Severity of the disease / condition | Target disease |
- Population size | - Severity of the disease | |
-Unmet need / availability of alternatives | -Determinants of the disease | |
-Burden of illness / threat to life | ||
-Economic burden of the disease | ||
-Epidemiology | ||
Therapeutic context | ||
-Therapeutic alternatives / need not met | ||
-Need | ||
-Clinical practice guidelines and protocols | ||
-Existing use | ||
Health results | -Benefits in health / clinical | Clinical benefits |
-Efficacy / Effectiveness | - General clinical benefits | |
- Safety / tolerability | -Effect on mortality | |
-Health perceived by the patient | -Effect on longevity | |
-Quality of care | -Effect on quality of life | |
Health perceived by the patient: | ||
-Quality of life | ||
- Autonomy | ||
- Impact on dignity | ||
- Improved use / administration | ||
Adequacy | ||
- Efficiency and safety | ||
- Effectiveness | ||
Response level | ||
- Quality of care received by the patient | ||
- Burden of disease | ||
Type of benefit of the intervention | -Preventive benefits | |
-Therapeutic benefits | ||
Economic consequences / economic impact | -Costs of the intervention | Efficiency |
- Medical / health costs | - Cost effectiveness / benefit | |
- Non-medical costs (productivity, cost, patients, caregivers) | - Budget impact | |
-Impoverishment for the patient | - Costs | |
- Budget impact | Financing | |
-Financial impact | - Unit cost | |
-Impact on productivity | - Budget impact | |
-Impact on other services | - Financing agent | |
-Efficiency and opportunity cost | Cost of opportunity and affordability (context-dependent criteria) | |
-Cost-effectiveness | - Opportunity cost and if the system can afford it | |
Existing knowledge about the intervention / Quality and uncertainty of the evidence | -Evidence available | Other considerations |
-Quality of the evidence | Quality of clinical and economic evidence | |
-Relevance of the evidence | Consistency with strategic aspects | |
-Uncertainty of the evidence | ||
-Expert consensus / clinical practice guidelines | ||
Implementation and complexity of the intervention / Feasibility | -Regulatory requirements / legislation | |
-Organizational requirements | ||
-Technological requirements | ||
-Requirements of personnel | ||
-Training / personal skills requirements | ||
-Information requirements | ||
-Implementation flexibility | ||
-Features of the intervention | ||
-Appropriate use | ||
-Barriers and acceptability | ||
-Integration and efficiency of the system | ||
-Sustainability | ||
-Accessibility to the population | ||
Ethics and justice | -Population priorities | Priority, ethics and justice |
-Access | - Low socioeconomic status | |
-Vulnerability | - Children (0–5 years old or elderly) | |
-Utility | - Subjects of productive age | |
-Solidarity | - Women in productive age | |
-Ethics and moral aspects | - Remote communities | |
- Therapeutic specific areas | ||
- Response behavior | ||
- Rare diseases | ||
- Specific groups of patients | ||
Equity | ||
- General | ||
- Accessibility | ||
- Accessibility for the individual | ||
Other ethical and social values | ||
- Autonomy | ||
- Value public health | ||
- Impact in future generations | ||
- Risk social and financial | ||
- Catastrophic sanitary cost | ||
- Economic productivity and care for third parties | ||
- Rare diseases-Population priorities | ||
Global context | -Mandate and mission of the health system | Governance / leadership |
-Alignment with regulations and strategies | - Congruence with prior prioritization | |
- Global priorities / alignment with priority lines (vulnerable groups, disabled, diseases, rare, etc.) | - Cultural acceptability | |
-Financial Restriction | - Political acceptability | |
-Incentives | - Acceptability of interest groups | |
-Political aspects | - Legal Barriers | |
- Historical aspects | ||
-Cultural aspects | ||
-Degree of innovation | ||
-Collaboration and leadership | ||
-Implementation of patients | ||
-Pressure of different interest groups | ||
-Environmental impact |