Objectives: The purpose of this research is to identify the attributes to include in an orphan medicinal product (OMP) value framework, determine their relative importance via a multi-criteria decision analysis (MCDA) process, and test whether an MCDA approach can practically support decision...

Background: It is often assumed that the objective of health care is to maximise health using available resources. This is the principle underpinning NICE's use of cost effectiveness analysis based on incremental cost per QALY gained. Yet research on local NHS decision making shows that cost per...