IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v120y2016i3p246-251.html
   My bibliography  Save this article

A new proposal for priority setting in Norway: Open and fair

Author

Listed:
  • Ottersen, Trygve
  • Førde, Reidun
  • Kakad, Meetali
  • Kjellevold, Alice
  • Melberg, Hans Olav
  • Moen, Atle
  • Ringard, Ånen
  • Norheim, Ole Frithjof

Abstract

Health systems worldwide struggle to meet increasing demands for health care, and Norway is no exception. This paper discusses the new, comprehensive framework for priority setting recently laid out by the third Norwegian Committee on Priority Setting in the Health Sector. The framework posits that priority setting should pursue the goal of “the greatest number of healthy life years for all, fairly distributed” and centres on three criteria: 1) The health-benefit criterion: The priority of an intervention increases with the expected health benefit (and other relevant welfare benefits) from the intervention; 2) The resource criterion: The priority of an intervention increases, the less resources it requires; and 3) The health-loss criterion: The priority of an intervention increases with the expected lifetime health loss of the beneficiary in the absence of such an intervention. Cost-effectiveness plays a central role in this framework, but only alongside the health-loss criterion which incorporates a special concern for the worse off and promotes fairness. In line with this, cost-effectiveness thresholds are differentiated according to health loss. Concrete implementation tools and open processes with user participation complement the three criteria. Informed by the proposal, the Ministry of Health and Care Services is preparing a report to the Parliament, with the aim of reaching political consensus on a new priority-setting framework for Norway.

Suggested Citation

  • Ottersen, Trygve & Førde, Reidun & Kakad, Meetali & Kjellevold, Alice & Melberg, Hans Olav & Moen, Atle & Ringard, Ånen & Norheim, Ole Frithjof, 2016. "A new proposal for priority setting in Norway: Open and fair," Health Policy, Elsevier, vol. 120(3), pages 246-251.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:3:p:246-251
    DOI: 10.1016/j.healthpol.2016.01.012
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851016000269
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2016.01.012?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Calltorp, Johan, 1999. "Priority setting in health policy in Sweden and a comparison with Norway," Health Policy, Elsevier, vol. 50(1-2), pages 1-22, December.
    2. Kapiriri, Lydia & Norheim, Ole Frithjof & Martin, Douglas K., 2007. "Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda," Health Policy, Elsevier, vol. 82(1), pages 78-94, June.
    3. E. Wetering & E. Stolk & N. Exel & W. Brouwer, 2013. "Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 107-115, February.
    4. Musgrove, Philip, 1999. "Public spending on health care: how are different criteria related?," Health Policy, Elsevier, vol. 47(3), pages 207-223, May.
    5. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    6. Simon Eckermann & Brita Pekarsky, 2014. "Can the Real Opportunity Cost Stand Up: Displaced Services, the Straw Man Outside the Room," PharmacoEconomics, Springer, vol. 32(4), pages 319-325, April.
    7. Ham, Chris, 1997. "Priority setting in health care: learning from international experience," Health Policy, Elsevier, vol. 42(1), pages 49-66, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Johansson, Kjell Arne & Nygaard, Elizabeth & Herlofsen, Berit & Lindemark, Frode, 2017. "Implementation of the 2013 amended Patients’ Rights Act in Norway: Clinical priority guidelines and access to specialised health care," Health Policy, Elsevier, vol. 121(4), pages 346-353.
    2. Matthijs M. Versteegh & Isaac Corro Ramos & Nasuh C. Buyukkaramikli & Amir Ansaripour & Vivian T. Reckers-Droog & Werner B. F. Brouwer, 2019. "Severity-Adjusted Probability of Being Cost Effective," PharmacoEconomics, Springer, vol. 37(9), pages 1155-1163, September.
    3. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    4. Melberg, Andrea, 2024. "Open and opaque? The performativity of open priorities in a Norwegian hospital," Social Science & Medicine, Elsevier, vol. 361(C).
    5. Ulrikke J. V. Hernæs & Kjell A. Johansson & Trygve Ottersen & Ole F. Norheim, 2017. "Distribution-Weighted Cost-Effectiveness Analysis Using Lifetime Health Loss," PharmacoEconomics, Springer, vol. 35(9), pages 965-974, September.
    6. Erik Nord, 2018. "Beyond QALYs: Multi-criteria based estimation of maximum willingness to pay for health technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 267-275, March.
    7. V. Meusel & E. Mentzakis & P. Baji & G. Fiorentini & F. Paolucci, 2023. "Priority setting in the German healthcare system: results from a discrete choice experiment," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 411-431, September.
    8. Reckers-Droog, V.T. & van Exel, N.J.A. & Brouwer, W.B.F., 2018. "Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands," Health Policy, Elsevier, vol. 122(6), pages 621-629.
    9. Hausman, Daniel M., 2024. "Problems with NICE's severity weights," Social Science & Medicine, Elsevier, vol. 348(C).
    10. Werner Brouwer & Pieter Baal & Job Exel & Matthijs Versteegh, 2019. "When is it too expensive? Cost-effectiveness thresholds and health care decision-making," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 175-180, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Broqvist, Mari & Sandman, Lars & Garpenby, Peter & Krevers, Barbro, 2018. "The meaning of severity – do citizenś views correspond to a severity framework based on ethical principles for priority setting?," Health Policy, Elsevier, vol. 122(6), pages 630-637.
    2. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    3. Shah, Koonal K. & Tsuchiya, Aki & Wailoo, Allan J., 2015. "Valuing health at the end of life: A stated preference discrete choice experiment," Social Science & Medicine, Elsevier, vol. 124(C), pages 48-56.
    4. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    5. Wouters, S. & van Exel, N.J.A. & Rohde, K.I.M. & Vromen, J.J. & Brouwer, W.B.F., 2017. "Acceptable health and priority weighting: Discussing a reference-level approach using sufficientarian reasoning," Social Science & Medicine, Elsevier, vol. 181(C), pages 158-167.
    6. Franken, Margreet & Stolk, Elly & Scharringhausen, Tessa & de Boer, Anthonius & Koopmanschap, Marc, 2015. "A comparative study of the role of disease severity in drug reimbursement decision making in four European countries," Health Policy, Elsevier, vol. 119(2), pages 195-202.
    7. Nord, Erik, 2012. "Measuring concerns for severity: Re-examination of a health scale with purported equal interval properties," Health Policy, Elsevier, vol. 105(2), pages 312-316.
    8. Nord, Erik & Johansen, Rune, 2014. "Concerns for severity in priority setting in health care: A review of trade-off data in preference studies and implications for societal willingness to pay for a QALY," Health Policy, Elsevier, vol. 116(2), pages 281-288.
    9. Erik Nord & Rune Johansen, 2015. "Transforming EQ-5D utilities for use in cost–value analysis of health programs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 313-328, April.
    10. Golan, Ofra & Hansen, Paul & Kaplan, Giora & Tal, Orna, 2011. "Health technology prioritization: Which criteria for prioritizing new technologies and what are their relative weights?," Health Policy, Elsevier, vol. 102(2), pages 126-135.
    11. Herlitz, Anders & Horan, David, 2016. "Measuring needs for priority setting in healthcare planning and policy," Social Science & Medicine, Elsevier, vol. 157(C), pages 96-102.
    12. Jang, Sung-In & Nam, Jung-Mo & Choi, Jongwon & Park, Eun-Cheol, 2014. "Disease management index of potential years of life lost as a tool for setting priorities in national disease control using OECD health data," Health Policy, Elsevier, vol. 115(1), pages 92-99.
    13. Reckers-Droog, V.T. & van Exel, N.J.A. & Brouwer, W.B.F., 2018. "Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands," Health Policy, Elsevier, vol. 122(6), pages 621-629.
    14. Haeder, Simon F., 2014. "Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act," Health Policy, Elsevier, vol. 118(3), pages 285-291.
    15. Anca-Stefania SAVA, 2011. "Challenges of Using Cost-effectiveness Analysis in Rationalizing Health Care Public Spending," Economics and Applied Informatics, "Dunarea de Jos" University of Galati, Faculty of Economics and Business Administration, issue 2, pages 55-60.
    16. Erik Nord, 2015. "Cost-Value Analysis of Health Interventions: Introduction and Update on Methods and Preference Data," PharmacoEconomics, Springer, vol. 33(2), pages 89-95, February.
    17. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    18. Sofaer, Neema & Kapiriri, Lydia & Atuyambe, Lynn M. & Otolok-Tanga, Erasmus & Norheim, Ole Frithjof, 2009. "Is the selection of patients for anti-retroviral treatment in Uganda fair?: A qualitative study," Health Policy, Elsevier, vol. 91(1), pages 33-42, June.
    19. Salome A. Bukachi & Washington Onyango-Ouma & Jared Maaka Siso & Isaac K. Nyamongo & Joseph K. Mutai & Anna Karin Hurtig & Øystein Evjen Olsen & Jens Byskov, 2014. "Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework," International Journal of Health Planning and Management, Wiley Blackwell, vol. 29(4), pages 342-361, October.
    20. Anna Nicolet & Antoinette D I van Asselt & Karin M Vermeulen & Paul F M Krabbe, 2020. "Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-18, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:120:y:2016:i:3:p:246-251. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.