Is the Link between Health and Wealth Considered in Decision Making? Results from a Qualitative Study

Objectives: This research was intended to explore whether wealth effects of drug interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. It also analyses reasons for including, or not including, wealth effects. Methods: Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden and the UK) were concluded.Results: The principle that investment in health care, including drug interventions, can improve economic outputs does not influence decision making in any country included in our study, with the exception of Sweden. A combination of factors are responsible, including system ragmentation that does not allow spillovers across sectors to be considered, methodological issues in HTA, and a focus on short-term measures by national governments that are dealing the effects of the economic recession.Conclusions: If the aim of HTA agencies is to inform efficient priority setting within the health care sector, they should take into account all relevant costs and benefits generated by individual interventions when making decisions. A clear signal from HTA bodies to consider wealth effects systematically will encourage biopharmaceutical companies to invest in generating the evidence that demonstrates the presence and size of those effects.This also should apply to government decisions about resource allocation across sectors. Governments should consider all relevant effects from public investments, including health care, even when benefits can be captured only in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns