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The Norwegian National Council for Priority Setting in Health Care: decisions and justifications1

Published online by Cambridge University Press:  21 March 2017

Gry Wester  and
Berit Bringedal
Gry Wester*
Affiliation:
Department of Global Public Health and Primary Care, University of Bergen, Norway
Berit Bringedal
Affiliation:
The Institute for Studies of the Medical Profession, Oslo, Norway Center on Medicine as a Profession, Columbia College of Physicians & Surgeons, Columbia University, New York, USA
*
*Correspondence to: Gry Wester, Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway. Email: gry.wester@uib.no
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Abstract

Different countries have adopted different strategies for tackling the challenge of allocating scarce health care resources fairly. Norway is one of the countries that has pioneered the effort to resolve priority setting by using a core set of priority-setting criteria. While the criteria themselves have been subject to extensive debate and numerous revisions, the question of how the criteria have been applied in practice has received less attention. In this paper, we examine how the criteria feature in the decisions and justifications of the Norwegian National Council for Priority Setting in Health Care, which has played an active role in deliberating about health care provision and coverage in Norway. We conducted a comprehensive document analysis, looking at the Council’s decisions about health care allocation as well as the reasons they had provided to justify their decisions. We found that although the Council often made use of the official priority-setting criteria, they did so in an unsystematic and inconsistent manner.

Type
Articles
Information
Health Economics, Policy and Law , Volume 13 , Issue 2 , April 2018 , pp. 118 - 136
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Copyright
© Cambridge University Press 2017 

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Footnotes

1

Author 1 has no prior or current engagement with the Council. Author 2 was previously in the Secretariat of the first Priority Council, from 2002 to 2006.

References

Agenda Kaupang (2015), Evaluering av Nasjonalt råd for kvalitet og prioritering i helse- og omsorgstjenesten [Evaluating the National Council for Quality and Priority Setting in Health Care], Stabekk: Report no. 8746. Ministry of Health and Care Services.Google Scholar
Berg, M. and van der Grinten, T. (2003), ‘The Netherlands’, in C. Ham and R. Glenn (eds), Reasonable Rationing: International Experience of Priority Setting in Health Care, Maidenhead: Open University Press.Google Scholar
Bringedal, B. (2015), ‘Verdensmester i teoretisk prioritering’ [World champions in theoretical priority setting], Nytt Norsk Tidsskrift, 1: 79–86.Google Scholar
Calltorp, J. (1999), ‘Priority setting in health policy in Sweden and a comparison with Norway’, Health Policy, 50(1–2): 1–22.Google Scholar
Culyer, A. J. (2006), ‘NICE’s use of cost effectiveness as an exemplar of a deliberative process’, Journal of Health Economics, Policy and Law, 1: 299–318.Google Scholar
Devlin, N. and Parker, D. (2004), ‘Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis’, Health Economics, 13: 437–452.Google Scholar
Directorate of Health (2012), Prioriteringer i Helsesektoren: Verdigrunnlag, Status og Utfordringer [Priority Setting in the Health Sector: Core Values, Status and Challenges], Oslo: Norwegian Directorate of Health.Google Scholar
Directorate of Health (2015), På ramme alvor: Alvorlighet og prioritering [Severity and Priority], Oslo: Norwegian Directorate of Health.Google Scholar
Johansson, K. A., Miljeteig, I. and Norheim, O. F. (2009), ‘Høykostnadsmedisin – mangler vi åpne og legitime prosedyrer for prioritering?’ [High cost drugs – do we lack open and transparent procedures for priority setting?], Journal of the Norwegian Medical Association, 129: 17–20.Google Scholar
Kapiriri, L., Norheim, O. F. and Martin, D. K. (2007), ‘Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda’, Health Policy, 82(1): 78–94.Google Scholar
Landwehr, C. and Klinnert, D. (2015), ‘Value congruence in health care priority setting: social values, institutions and decisions in three countries’, Health Economics, Policy and Law, 10: 113–132.Google Scholar
Mørland, B., Ringard, Å. and Røttingen, J-A. (2010), ‘Supporting tough decisions in Norway: a healthcare system approach’, International Journal of Technology Assessment in Health Care, 26: 298–404.Google Scholar
Nasjonal helseplan [National Health Plan] (2007-2010), https://www.regjeringen.no/no/tema/helse-og-omsorg/sykehus/sykehus-i-norge/id115230/ [15 December 2015].Google Scholar
Norheim, O. F. (2003), ‘Norway’, in C. Ham C and G. Robert G (eds), Reasonable Rationing, Philadelphia, PA: Open University Press.Google Scholar
Norges Offentlige Utredning [Official Norwegian Report] (2014), Åpent og rettferdig – prioriteringer i helsetjenesten [Open and fair – priority setting in the health care services], NOU 2014: 12, Oslo.www.regjeringen.no/no/dokumenter/NOU-2014-12/id2076730/ [15 December 2015].Google Scholar
Norges Offentlige Utredning [Official Norwegian Report] (1997), Prioritering på ny – Gjennomgang av retningslinjer for prioriteringer innen norsk helsetjeneste [Priority setting revisited – review of guidelines for priority setting in the Norwegian health care services], NOU 1997: 18, Oslo.www.regjeringen.no/nb/dep/hod/dok/nouer/1997/nou-1997-18/4.html?id=140960 [15 December 15].Google Scholar
Patient Rights Act LOV-1999-07-02-63 www.lovdata.no/all/hl-19990702-063.html [10 August 2015].Google Scholar
Regulation on Medicines: FOR-2010-06-23-957, https://lovdata.no/dokument/SF/forskrift/2009-12-18-1839 [15 December 2015].Google Scholar
Regulation on Priority Setting FOR-2000-12-01-1208, https://lovdata.no/dokument/SF/forskrift/2000-12-01-1208?q=FOR-2000-12-01-1208 [15 December 2015].Google Scholar
Regulation on Priority Setting FOR-2015-04-10-339, https://lovdata.no/dokument/SF/forskrift/2000-12-01-1208?q=FOR-2000-12-01-1208 [15 December 2015].Google Scholar
Ringard, Å., Larsen, B. I. and Norheim, O. F. (2012), ‘Medisinsk metodevurdering (HTA) for bedre prioriteringer av helsetjenester’ [Health technology assessment for better priority setting in the health care services], Michael, 9: 174–182.Google Scholar
Ringard, Å., Mørland, B. and Larsen, B. I. (2012), ‘Quality and priorities in the health services’, Journal of the Norwegian Medical Association, 3: 312–314.Google Scholar
Ringard, Å., Mørland, B. and Røttingen, J-A. (2010), ‘Åpne prosesser for prioritering’ [Open process for priority setting], Journal of the Norwegian Medical Association, 130: 2264–2266.Google Scholar
Robberstad, B. (2015), ‘Age and severity’, Journal of the Norwegian Medical Association, 135: 1376–1378.Google Scholar
Rumbold, B. E., Weale, A., Rid, A., Wilson, J. and Littlejohns, P. ( forthcoming), ‘Public reasoning and health care priority setting: the case of NICE’, Kennedy Institute of Ethics Journal.Google Scholar
Wang, H. and Høymork, C. (2014), ‘Er alle gode ting tre?’ [Are three criteria sufficient for priority setting?], Journal of the Norwegian Medical Association, 134: 1260–1262.Google Scholar
Website for the Norwegian National Council for Priority Setting in Health Care: (2015), http://www.kvalitetogprioritering.no/hjem [15 December 2015].Google Scholar
Wilson, J.M.G. and Jungner, G. (1968), Principles and practice of screening for disease, Geneva: WHO.Google Scholar
Wisløff, T. (2015), ‘Priority-setting criteria in the Norwegian health services’, Journal of the Norwegian Medical Association, 135: 1373–1375.Google Scholar