REVISE2020 is a collaborative research program between leading policy makers and researchers worldwide, coordinated by Radboudumc, the Netherlands.
REVISE2020 aims to revise the theory and methods for priority setting. More specifically, we want to support HTA agencies around the world, including the Netherlands, in the development of their priority setting process. We aim to optimize the way they make their decisions, in terms of stakeholder involvement and transparency, and thereby the legitimacy of forthcoming decisions.
We have now developed evidence-informed deliberative processes for this purpose. By 2020, we will have: i) developed practical guidance on these processes; ii) implemented and evaluated their use in various contexts; and iii) made tools available for wider implementation.
Priority setting is recognized since long as a value-laden political process, in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Yet, present theory and methods for priority setting do not reflect this, and are typically technocratic in nature. This risks to jeopardize the legitimacy of decisions.
We consider legitimacy, or perceived reasonableness of decisions, as the key challenge of priority setting in the coming decades. HTA agencies need to manoeuvre between the rapid development of new technologies and ever-expanding pressures on health budgets on the one hand, and strong stakeholder voices demanding access to these technologies on the other hand. HTA agencies are increasingly scrutinized on how they make decisions, including their process and evidence used. In various countries, compromised legitimacy results in people challenging HTA agencies in court.
We have developed ‘evidence-informed deliberative processes’ as a generic value assessment framework which HTA agencies can adopt to their own needs and affordances. The framework integrates elements from MCDA and A4R, and is based on stakeholder deliberation on the one hand, and reasoned decision-making through evaluation of the identified values on the other hand.
There are many initiatives on value assessment frameworks worldwide, often similar in principles but different in presentation. We therefore reach out to leading policy makers and researchers to jointly further develop, implement and evaluate evidence-informed deliberative processes. We do this by holding expert and dissemination meetings. In addition, we undertake case studies to illustrate the work.