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Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art

Monica Oliveira (), Inês Mataloto and Panos Kanavos

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: Background: Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA in the context of HTA by assessing their methodological quality and summarising methodological challenges. Methods: A systematic review was conducted to identify studies discussing, developing or reviewing the use of MCDA in HTA using aggregation approaches. Studies were classified according to publication time and type, country of study, technology type and study type. The PROACTIVE-S approach was constructed and used to analyse methodological quality. Challenges and limitations reported in eligible studies were collected and summarised; this was followed by a critical discussion on research requirements to address the identified challenges. Results: 129 journal articles were eligible for review, 56% of which were published in 2015–2017; 42% focused on pharmaceuticals; 36, 26 and 18% reported model applications, issues regarding MCDA implementation analyses, and proposing frameworks, respectively. Poor compliance with good methodological practice (

Keywords: health technology assessment; MCDA modelling; methodological challenges; methodological quality; multi-criteria decision analysis; systematic review (search for similar items in EconPapers)
JEL-codes: I10 I18 C44 D80 (search for similar items in EconPapers)
Pages: 28 pages
Date: 2019-08-01
New Economics Papers: this item is included in nep-hea
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Published in European Journal of Health Economics, 1, August, 2019, 20(6), pp. 891-918. ISSN: 1618-7598

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