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

Author

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  • 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
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    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.

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