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Table 2 Specific points to consider when applying PBMA

From: Health care priority setting: principles, practice and challenges

Point to consider

Ideal time to address

Rationale

Strategically select the first PBMA exercise in a health organization in an area where there is a confirmed champion and an 'easy-win'

Prior to specific applications being selected

Need champion for group buy-in and follow-through of recommendations; early success will aid in the organizational uptake of the approach

Use an introductory session to communicate underlying economic concepts and specifically what the application plan is

At the outset of the process

Panel members have to understand opportunity cost for buy-in; provides opportunity to adjust the plan early on

Advisory panel meetings held at 2–4 week intervals

Throughout the PBMA process

Need adequate time to review literature and do background work but do not want a drawn out process; complete in < 6 months

Consider using one-on-one meetings with advisory panel members to identify options for resource release

When discussing options for resource release

Not all members will feel comfortable presenting a view in the larger group

Put less emphasis on having all the 'data' to support a decision and more on drawing out opinions from the expert group

Particularly in the later sessions of the process

Data can only take the group so far and can be used as a crutch not to make a decision; ultimately group need to have confidence in making their own recommendations

Earmark resources (i.e. staff time) to enact the panel recommendations

Stated at the outset, carried out following the exercise

Recommendations by themselves will not see action without dedicated resources to move them forward

Reliance on 'softer' forms of evidence to support process such as expert opinions and qualitative research, particularly when 'hard' evidence is not available

Throughout PBMA process

This is the type of information decision makers are familiar with and which is often available in practice

Tap into public for development of criteria on which decisions are to be based

At the outset of the process

Public may not have technical knowledge to make specific trade-offs but certainly can offer valuable insight on values and specific criteria