Weighing Price and Performance for Decisions for Multisource Pharmaceutical Bidding in Public Hospitals in Thailand

Following a national law introduced in 2017 in Thailand, the selection of winning bidders for multisourced pharmaceuticals and medical supplies in public hospitals must reflect "price-performance" aligned with the principles of worthiness, transparency, efficiency, effectiveness and accountability. We describe how a practical tool using Multiple Criteria Decision Analysis (MCDA) for evidence-based decision making in hospital bidding (tender) was developed through a multi-stakeholder workshop format. The local leader of the initiative together with 2 international advisors guided the 37 workshop participants through five interactive steps for local adaptation of the previously developed and validated global MCDA-tool: (1) Criteria selection, (2) Scoring definition, (3) Weighting of price criterion, (4) Definition of cut-off point for price criterion, (5) Ranking and weighting of remaining criteria. All consensus judgments were imported to the decision tool which can later be used in the real-world situation in the hospitals to support the selection and document the underlying rationale. The final list of criteria differs from the previously suggested international template and now reflects the Thai decision priorities and current decision processes. In the book chapter, the resulting model will be presented and a pathway for implementation will be discussed.