The most important barriers and facilitators to the use of HTA by policy makers

Abstract

Background: Different studies have identified multiple barriers and facilitators to the uptake of HTA information by policy makers. However, these studies do not evaluate the importance of each of these factors. Hence, we elicited– using best-worst scaling (BWS) - the most important barriers and facilitators and its relative weight to the use of HTA by policy makers. Methods: Two BWS object case surveys (one for barriers, one for facilitators) were used among 16 policy makers and 33 HTA experts from the Netherlands. A list of 22 barriers and 19 facilitators was identified. In each choice task, participants were asked to choose the most important and the least important barrier/facilitator from a set of five from the master list. We used Hierarchical Bayes modeling to generate the mean relative importance score (RIS) for each factor and subgroup analysis was conducted to assess differences between policy makers and HTA experts. Findings: The five most important barriers (RIS > 6.00) were ‘no guidelines’, ‘inadequate presentation format’, ‘absence of policy networks’ , ‘no access to relevant HTA research’, and ‘lack of longstanding relation’. The five most important facilitators were: ‘Clear presentation format’, ‘Creation of policy networks’, ‘Sufficient legal support’, ‘More personal contact and interaction’, and ‘Availability of guidelines’. Discussion: This study contributes to literature by assessing the most important barriers and facilitators of the use of HTA. This resulted in a list of factors that are malleable and important to enhance usage of HTA. Overall, policy makers and HTA-experts did not differ in perceptions.