Designing multi-criteria decision analysis processes for priority setting in health policy

Public health policymaking has far-reaching impacts on society. A sound policymaking process should provide for thorough assessment, followed by a careful balancing of scientific evidence and policy goals. This paper reports on two instances of a participatory multi-criteria decision analysis (MCDA) approach to priority setting as part of public health policymaking in the Netherlands. The first case describes the process of locating the most important health problems by ranking (clusters of) diseases in terms of their impact on public health. The second case describes the process of setting an agenda for efficiency improvements in the Dutch health care sector. The article focuses on the ways in which these processes were designed and implemented, and on the specific group MCDA support technology that was used. The similarities and differences in process design in the two cases are related to their respective outcomes, revealing the strengths and weaknesses of the approach.