How can we improve priority-setting for investments in health research? A case study of tuberculosis

Creating a priority list of non-communicable diseases to support health research funding decision-making

OBJECTIVE

To develop and pilot a framework based on multi-criteria decision analysis (MCDA) to prioritize non-communicable diseases (NCDs) to support health research funding decision-making.

METHODS

The framework involves identifying NCDs to be prioritized, specifying prioritization criteria and determining their weights from a survey of stakeholders. The mean weights from the survey are applied to the NCDs' ratings on the criteria to generate a 'total score' for each NCD, by which the NCDs are prioritized.

RESULTS

Nineteen NCDs and five criteria were included. The criteria, in decreasing order of importance (mean weights in parentheses), are: deaths across the population (27.7 %), loss of quality-of-life across the population (23.0 %), cost to patients and families (18.6 %), cost to the health system (17.2 %), and whether vulnerable groups are disproportionately affected (13.4 %). The priority list of NCDs, stratified into four tiers of importance, is: 'Very critical' priority: coronary heart disease, back and neck pain, diabetes mellitus; 'Critical' priority: dementia and Alzheimer's disease, stroke; 'High' priority: colon and rectum cancer, depressive disorders, chronic obstructive pulmonary disease, chronic kidney disease, breast cancer, prostate cancer, arthritis, lung cancer; and 'Medium' priority: asthma, hearing loss, melanoma skin cancer, addictive disorders, non-melanoma skin cancer, headaches.

CONCLUSION

The results indicate the framework for prioritizing NCDs for research funding is feasible and effective. The framework could also be used for other health conditions.