Going from evidence to dis-coverage decisions

Article type
Authors
Parmelli E1, Davoli M2, Amato L3, D’Amico R4, Moja L5, Pregno S6, Brunetti M6, Saitto C7
1Italian Cochrane Network, Italy
2Drugs and Alcohol Group-Dept Epidemiology Rome, Italy
3Cochrane Drugs and alcohol Group; Department of Epidemiology Lazio Regional Health System, Italy
4Italian Cochrane Centre - University of Modena and Reggio Emilia, Italy
5Univerity of Milan, Italy
6Local Health Unit, Modena, Italy
7Local Health Unit, Rome, Italy
Abstract
Objectives:

To introduce, discuss and further develop a framework for going from evidence to decisions about disinvesting partially or completely on drugs, tests, devices, procedures or services that are considered of low clinical-value (dis-coverage decision).

Description:

The workshop will include brief presentations and group discussions. A conceptual framework will be presented, developed based on a review of the literature and stakeholder consultations, that incorporates key dimensions for taking coverage decisions and that will be applied to practical case studies of low clinical-value interventions (LCVIs). Participants will discuss evidence and its quality and then make dis-coverage recommendations mimicking real panel decision making. The application of the framework to decisions about disinvesting on LCIVs pertains to the need of an explicit and transparent way to rationalise national healthcare systems’ resources. We will conclude by discussing ways in which the framework could be further improved and how it could be presented to facilitate dis-coverage decisions informed by research evidence. The workshop will contribute to DECIDE (www.decide-collaboration.eu), a 5-year project funded by the European Commission’s FP7 that, building on the work of GRADE, aims at improving the dissemination of guidelines. Partners in DECIDE include members of the GRADE Working Group and four Cochrane Centres.