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Table 4 Case study—Colombia [38, 39]

From: Incorporating MCDA into HTA: challenges and potential solutions, with a focus on lower income settings

With the cost of medications and devices seen as a threat to the sustainability of the funding of the health care system, between 2011 and 2013 the Instituto de Evaluación Tecnológica en Salud (IETS) implemented an MCDA to inform the inclusion of technologies in the health benefits package. The Ministry of Health undertook a systematic review to identify criteria, from which a shortlist was selected by relevant stakeholders. Technologies are scored against the criteria using 5-point Likert scales by stakeholders including Ministry of Health staff, citizens and physicians. Weights were obtained from a survey of 200 people from the Colombian general population

The MCDA informed the decision about additions to the health benefits package in 2013. Technologies that were candidates for inclusion but did not make it into the benefits package in 2011, as well as technologies that the judiciary had made available to individual patients, made up the list of 314 technologies considered. The Ministry of Health prioritised 105 technologies for evaluation based on disease burden and the number of requests via tutela (the judicial mechanisms to request technologies not included in the benefits package). Based on the MCDA benefit-score and the available budget, 70 technologies were included in the benefits package