scholarly journals What is driving HTA decision-making? Evidence from cancer drug reimbursement decisions from 6 European countries

Health Policy ◽  
2019 ◽  
Vol 123 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Laia Maynou ◽  
John Cairns
Keyword(s):  
Decision Making ◽  
European Countries ◽  
Cancer Drug ◽  
Drug Reimbursement

scholarly journals Disagreement on cancer drug decisions in Europe

2020 ◽  
Vol 36 (3) ◽  
pp. 232-238
Author(s):  
Laia Maynou ◽  
John Cairns
Keyword(s):  
European Union ◽  
Health Technology ◽  
European Countries ◽  
Primary Data ◽  
Cancer Drug ◽  
The European Union ◽  
Reliability Measures ◽  
Drug Reimbursement ◽  
Two Measures ◽  
Voluntary Cooperation

ObjectivesDespite the efforts of the European Union (EU) to promote voluntary cooperation among Health Technology Assessment (HTA) agencies, different reimbursement decisions for the same drug are made across European countries. The aim of this paper is to compare the agreement of cancer drug reimbursement decisions using inter-rater reliability measures.MethodsThis study is based on primary data on 161 cancer drug reimbursement decisions from nine European countries from 2002 to 2014. To achieve our goal, we use two measures to analyze agreement, in other words, congruency: (i) percentage of agreement and (ii) the κ score.ResultsOne main conclusion can be drawn from the analysis. There is a weak to medium agreement among cancer drug decisions in the European countries analyzed (based on the percentage of agreement and the κ score). England and Scotland show the highest consistency between the two measures, showing a medium agreement. These results are in line with previous literature on the congruency of HTA decisions.ConclusionsThis paper contributes to the HTA literature, by highlighting the extent of weak to medium agreement among cancer decisions in Europe.

A comparative study of the role of disease severity in drug reimbursement decision making in four European countries

Health Policy ◽  
2015 ◽  
Vol 119 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Margreet Franken ◽  
Elly Stolk ◽  
Tessa Scharringhausen ◽  
Anthonius de Boer ◽  
Marc Koopmanschap
Keyword(s):  
Decision Making ◽  
Comparative Study ◽  
Disease Severity ◽  
European Countries ◽  
Reimbursement Decision ◽  
Drug Reimbursement

scholarly journals Ranking Environmental Aspects of Sustainable Tourism: Case of Selected European Countries

2021 ◽  
Vol 13 (10) ◽  
pp. 5701
Author(s):  
Tihana Škrinjarić
Keyword(s):  
Decision Making ◽  
Sustainable Tourism ◽  
Multiple Criteria Decision Making ◽  
Main Tool ◽  
Tourism Industry ◽  
European Countries ◽  
Environmental Aspects ◽  
Grey Systems Theory ◽  
Insightful Analysis ◽  
Critical Overview

The tourism industry is one of the fastest-growing industries today, and it is important to obtain insights into its good and bad practices. This will provide policymakers with as much information as possible to tailor specific policies to facilitate tourism and economic growth. The main purpose of this paper is a critical overview of the related research on the topic of evaluating sustainable tourism in European countries and extensive empirical research on achieving sustainable tourism. This research includes Grey Systems Theory (GST) as the main tool in evaluating the efficiency of sustainable tourism. Robustness checking is done via the multiple criteria decision making (MCDM) approach. Although the literature on tourism efficiency is vast, there is a smaller amount of research related to the approach taken in this paper. Thus, a comprehensive and insightful analysis will be done so that relevant and timely information can be obtained for the future decision-making process. Furthermore, a dynamic analysis will be provided so that changes in time can be observed and a detailed analysis can be made.

scholarly journals Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Timen ◽  
R Eilers ◽  
S Lockhart ◽  
R Gavioli ◽  
S Paul ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Infectious Diseases ◽  
Health Care Professionals ◽  
Elderly Care ◽  
European Countries ◽  
Decision Making Process ◽  
Ageing Population ◽  
Syncytial Virus

Abstract Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form. In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management. We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases. We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed. In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.

scholarly journals Unraveled Practices of Participatory Budgeting in European Democracies

2021 ◽  
pp. 287-313
Author(s):  
Juraj Nemec ◽  
David Špaček ◽  
Michiel S. de Vries
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Policy Diffusion ◽  
European Countries ◽  
Local Democracy ◽  
Participatory Budgeting ◽  
Porto Alegre ◽  
Marginalized Groups ◽  
The Status

AbstractThe goal of the final chapter was to summarize lessons about the worst and best practices, causes, and effects of (successful or unsuccessful) participatory budgeting, delivered by the country case studies included in this book. The information collected serves to check to what extent participatory budgeting as practiced in the countries involved presents a real attempt to change municipal budgets toward addressing the needs of marginalized groups and to improve decision-making based on local democracy and participation, or whether these processes as such are to be judged to be more important than any output and outcomes. All in all, the practices of PB as they evolved in European countries out of the innovative original as developed in Porto Alegre in the 1990s can be seen neither as a process of policy diffusion nor as a process of policy mimesis. The terminology of participatory budgeting remained, but the goals and tools to achieve the goals resulted only in marginal changes in the status quo in municipalities in European countries practicing participatory budgeting, instead of resulting in radical changes to increase spending in favor of marginalized groups. Participatory budgeting in selected European countries is far away from the level of “best practice” in which local democracy and participation are promoted. However, it is also not possible to conclude that all experiences are just “trivial pursuits”.

scholarly journals Identifying important health system factors that influence primary care practitioners’ referrals for cancer suspicion: a European cross-sectional survey

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022904 ◽  
Author(s):  
Michael Harris ◽  
Peter Vedsted ◽  
Magdalena Esteva ◽  
Peter Murchie ◽  
Isabelle Aubin-Auger ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Factor Analysis ◽  
Health System ◽  
Health Systems ◽  
European Countries ◽  
Cancer Symptoms ◽  
Referral Decision ◽  
System Factors ◽  
Primary Care Practitioners

ObjectivesCancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners’ (PCPs’) referral decisions is lacking.This study analyses health system factors potentially influencing PCPs’ referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.DesignBased on a content-validity consensus, a list of 45 items relating to a PCP’s decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs’ referral decision-making.SettingA primary care study; 25 participating centres in 20 European countries.Participants1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measuresThe factors derived from items related to PCPs’ referral decision-making. Mean factor scores were produced for each country, allowing comparisons.ResultsFactor analysis identified five underlying factors: PCPs’ ability to refer; degree of direct patient access to secondary care; PCPs’ perceptions of being under pressure; expectations of PCPs’ role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.ConclusionsFive healthcare system factors influencing PCPs’ referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

scholarly journals Needs-based decision-making for municipal health promotion – an analysis across 13 European countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Quilling ◽  
M Kuchler ◽  
J Leimann ◽  
S Dieterich ◽  
C Plantz
Keyword(s):  
Decision Making ◽  
Health Promotion ◽  
Success Factors ◽  
European Countries ◽  
Decision Making Process ◽  
Successful Implementation ◽  
Local Health ◽  
Healthy Living ◽  
Living Environments ◽  
Municipal Health

Abstract Introduction In contradiction to many recommendations, municipal health promotion often does not address identified needs. In order to create healthy living environments, all the 13 countries participating in Work package 6 - healthy living environments (WP6) of the EU Joint Action Health Equity Europe have been implementing feasible actions since autumn 2019 based on a country-specific needs analysis. They were supported on a theoretical level by the contents of the WP6 Implementation Template. The aim is to find out if and how the decision-making process from needs-based planning to the implementation of these measures in municipal health promotion was successful. Methods In order to gain an insight into the process 'from needs to action' and to obtain information about the methodological approach to implementation, guideline-based interviews were conducted with the project partners of WP6. These, as well as accompanying questionnaire-based interim reports, were evaluated comparatively in terms of content analysis according to Mayring and with regard to concrete evaluation criteria, obstacles and success factors during individual steps that can be transferred to the Public Health Action Cycle. Results The interim reports of the participating countries show that the step from an identified problem and related needs to a concrete, tailored action is often difficult. The relevant aspects mentioned above will be analysed more detailed during the interviews. It is to be expected that further insights can be gained from this, especially on successful implementation processes. Conclusions The mix of reports and interviews with participants from different European countries offers a broad view of the decision-making process in local health promotion and makes obstacles and success factors transparent for other actors in this field.

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