CP2 DO SOCIAL VALUES AND INSTITUTIONAL CONTEXT IMPACT THE USE OF ECONOMIC EVALUATION IN PRIORITY SETTING: EMPIRICAL EVIDENCE FROM OECD COUNTRIES

To empirically investigate if and how the use of economic evaluation in healthcare priority setting is influenced by social values and institutional context in a given country. We developed and tested a conceptual framework in the 36 OECD countries, divided in two groups based on their extent of use of economic evaluation in decision-making. The key social values were efficiency, equity and personal responsibility, measured in a pan-European survey. Countries were classified based on their institutional context in terms of both general paradigm of welfare system, type of healthcare system and according to the administrative tradition they belong to (Anglo-American, Germanic, Napoleonic, Scandinavian, Latin-American, Post-colonial, and Asian). We conducted a series of correlation and similarity tests to analyze association between the use of economic evaluation and other variables. There was significant correlation between Anglo-American administrative tradition and high use of economic evaluation (r=0.4077, p=0.014) while Social Health Insurance was significantly associated with low economic evaluation use (r=-0.3797, =0.032). Napoleonic countries reject personal responsibility in health (r=-0.459, p=0.021) while Germanic countries embrace it (r= 0.473, p= 0.017). Anglo-American countries exhibit a significant preference towards efficiency (r= 0.393, p= 0.052). No significant association was found between social values and use of economic evaluation. Preliminary results suggest that social values and institutional context do matter greatly when it comes to shaping the attitude towards the use of economic evaluation analysis in healthcare priority setting. While institutional context appears to have a direct influence, role of social values is more mediated through the administrative traditions present in different countries. These findings can help us better understand differences across countries and inform jurisdictions interested in expanding the use economic evaluation in decision making.