The use of non-economic criteria in pricing and reimbursement decisions in Central and Eastern Europe: issues, trends and recommendations

Expert Rev Pharmacoecon Outcomes Res. 2016 Aug;16(4):483-8. doi: 10.1080/14737167.2016.1215917.


Introduction: According to some experts, there is still room for improvement with regard to the inclusion of ethical considerations in Health Technology Assessment (HTA).

Areas covered: The pros and cons of the introduction of non-economic criteria in the HTA process in Central and Eastern Europe (CEE) are discussed. In comparison to Western Europe, financial considerations are even more important in CEE settings; however, it could also be said that attachment to equity and justice is part of CEE's heritage. Therefore, the trade-off between conflicting principles is evaluated. Expert commentary: To ensure the right balance between equity and efficiency in decision making, the current HTA framework has to be further augmented to allow all conflicting criteria to be addressed to a satisfactory degree. Following other examples, the applicability of multi criteria decision analysis technique to CEE settings should be further investigated.

Keywords: Central and Eastern Europe (CEE); Health technology assessment; cost effectiveness threshold; equity and justice; equity- efficiency trade-off; non-economic pricing and reimbursement criteria; pricing and reimbursement.

Publication types

  • Review

MeSH terms

  • Decision Making*
  • Decision Support Techniques
  • Europe
  • Europe, Eastern
  • Humans
  • Reimbursement Mechanisms / ethics
  • Reimbursement Mechanisms / organization & administration*
  • Reimbursement Mechanisms / trends
  • Technology Assessment, Biomedical / ethics
  • Technology Assessment, Biomedical / organization & administration*
  • Technology Assessment, Biomedical / trends