Open Access Methodology

Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis

Ole F Norheim1*, Rob Baltussen2, Mira Johri3, Dan Chisholm4, Erik Nord5, DanW Brock6, Per Carlsson7, Richard Cookson8, Norman Daniels9, Marion Danis10, Marc Fleurbaey11, Kjell A Johansson1, Lydia Kapiriri12, Peter Littlejohns13, Thomas Mbeeli14, Krishna D Rao15, Tessa Tan-Torres Edejer3 and Dan Wikler9

Author Affiliations

1 Department of Global Public Health and Primary Care, University of Bergen, PB 7800, 5020 Bergen, Norway

2 Nijmegen International Centre for Health Systems Research and Education (NICHE), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

3 Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Québec, Canada

4 Department of Health Systems Financing, World Health Organization, Geneva, Switzerland

5 Norwegian Institute of Public Health, Oslo, Norway

6 Harvard Medical School, Harvard University, Cambridge, USA

7 National Centre for Priority Setting in Health Care, Linköping University, Linköping, Sweden

8 Centre for Health Economics, University of York, York, UK

9 Harvard School of Public Health, Harvard University, Cambridge, USA

10 Section on Ethics and Health Policy, NIH Clinical Centre, Bethesda, USA

11 Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, USA

12 Department of Health, Aging, and Society, McMaster University, Hamilton, Canada

13 Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, King’s College London, Previous affiliation the National Institute for Health and Care Excellence (NICE), London, England, UK

14 Ministry of Health and Social Services, Windhoek, Namibia

15 Public Health Foundation of India, New Delhi, India

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Cost Effectiveness and Resource Allocation 2014, 12:18  doi:10.1186/1478-7547-12-18

Published: 29 August 2014


This Guidance for Priority Setting in Health Care (GPS-Health), initiated by the World Health Organization, offers a comprehensive map of equity criteria that are relevant to health care priority setting and should be considered in addition to cost-effectiveness analysis. The guidance, in the form of a checklist, is especially targeted at decision makers who set priorities at national and sub-national levels, and those who interpret findings from cost-effectiveness analysis. It is also targeted at researchers conducting cost-effectiveness analysis to improve reporting of their results in the light of these other criteria.

The guidance was develop through a series of expert consultation meetings and involved three steps: i) methods and normative concepts were identified through a systematic review; ii) the review findings were critically assessed in the expert consultation meetings which resulted in a draft checklist of normative criteria; iii) the checklist was validated though an extensive hearing process with input from a range of relevant stakeholders.

The GPS-Health incorporates criteria related to the disease an intervention targets (severity of disease, capacity to benefit, and past health loss); characteristics of social groups an intervention targets (socioeconomic status, area of living, gender; race, ethnicity, religion and sexual orientation); and non-health consequences of an intervention (financial protection, economic productivity, and care for others).

Priority setting; Resource allocation; Cost-effectiveness; Equity; Population health