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Developing a conceptual framework for going from evidence to coverage decisions

Date and Location




Monday 23 September 2013 - 10:30 - 12:00


Presenting author and contact person

Presenting author

Marina Davoli

Contact person

Laura Amato
Abstract text
Background: DECIDE, a 5-year project funded by the European Commission’s FP7, aims at improving the dissemination of evidence-based recommendations by building on the work of the GRADE Working Group to develop and evaluate methods that address the targeted dissemination of guidelines. Within this project we are developing tools to assist policymakers, managers and their staff to systematically and transparently consider factors that should influence decisions about whether to pay for the introduction of an intervention/option in a specifichealthcare setting (coverage decision). Objectives: To inform the development of a conceptual framework for going from evidence to coverage decision, using input collected through a structured consultation of our target audience. Methods: We developed a conceptual framework considering the following criteria: severity of the condition, benefits and harms of the proposed interventions, quality of evidence available, patients’ values, feasibility, equity and resource use. We consulted, through a structured feedback form, a convenient sample of 77 individuals from 6 Countries, collecting their opinions on the proposed framework. Results: To date, 49/77(63%) people responded:82% of them found the framework adequate for the intended purpose, gave positive judgments about its simplicity (83%) and usefulness (71%) and found it applicable to different types of coverage decisions (61%). However, these preliminary results show that only 43 % of the respondent considered the framework comprehensive: more detailed information are required for cost effectiveness, feasibility, production capacity, and contextual factors that impact on the decision-making process, such as ability to implement the procedure. Conclusions: The preliminary results show that the majority of the respondents found the framework adequate for the intended purpose, although not always applicable to different types of coverage decisions. Potential improvements for comprehensiveness have been suggested. On the basis of the full results of this consultation,the conceptual framework will be refined and then re-tested for its effectiveness.