A new proposal for priority setting in Norway: Open and Fair
A new article discusses the new, comprehensive framework for priority setting laid out by the third Norwegian Committee on Priority Setting in the Health Sector in November 2014. The authors also discuss the debate and work that followed in the wake of the Committee’s report.
Post. doc. Trygve Ottersen and professor Ole Frithjof Norheim from the Global Health Priorities research group have co-written a new article recently published in Health Policy. Here they present and discuss the new framework for priority setting introduced in the report "Open and fair - priority setting in the heath service" written by the the Norwegian Committee on Priority setting in the Health Sector. Background in norwegian here.
Health systems worldwide struggle to meet increasing demands for health care, and Norway is no exception. This paper discusses the new, comprehensive framework for priority setting recently laid out by the third Norwegian Committee on Priority Setting in the Health Sector.
The framework posits that priority setting should pursue the goal of “the greatest number of healthy life years for all, fairly distributed” and centres on three criteria: 1) The health-benefit criterion: The priority of an intervention increases with the expected health benefit (and other relevant welfare benefits) from the intervention; 2) The resource criterion: The priority of an intervention increases, the less resources it requires; and 3) The health-loss criterion: The priority of an intervention increases with the expected lifetime health loss of the beneficiary in the absence of such an intervention.
Cost-effectiveness plays a central role in this framework, but only alongside the health-loss criterion which incorporates a special concern for the worse off and promotes fairness. In line with this, cost-effectiveness thresholds are differentiated according to health loss. Concrete implementation tools and open processes with user participation complement the three criteria. Informed by the proposal, the Ministry of Health and Care Services is preparing a report to the Parliament, with the aim of reaching political consensus on a new priority-setting framework for Norway.
Citation: Trygve Ottersen, Reidun Førde, Meetali Kakad, Alice Kjellevold, Hans Olav Melberg, Atle Moen, Ånen Ringard, Ole Frithjof Norheim. A new proposal for priority setting in Norway: Open and fair. Health Policy. Available online 18 January 2016. http://dx.doi.org/10.1016/j.healthpol.2016.01.012.