Title: Involving stakeholders in policy research should not imply that they control the problem definition: lessons from a case study on new analgesics

Authors: Margriet Moret-Hartman, Gert Jan Van Der Wilt, John Grin

Addresses: Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Centre, Internal Postal Code 138, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands. ' Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Centre, Internal Postal Code 138, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands. ' Department of Political Science, University of Amsterdam, OZ Achterburgwal 237, Amsterdam 1012 DL, The Netherlands

Abstract: The Dutch Health Care Insurance Board (HCIB) commissions research to guide their policy recommendations. However, the studies conducted do not always yield relevant information. This may result from differences in problem definitions held by the HCIB and target populations. To compensate these problems, researchers were asked to analyse the problems from the perspective of the policy|s target populations. We analysed the HCIB|s commissioning approach when used in a tender for research proposals on new analgesics. The HCIB considered off-label use of these drugs to be problematic. Researchers, however, were reluctant to adopt the HCIB|s problem definition, questioning whether it would be shared by |the field|. Although most of the physicians did not consider their prescribing patterns to be problematic, one of the new drugs had to be withdrawn from the market because of severe side effects. These findings emphasise that involving target populations in policy research should not imply that they control the problem definition.

Keywords: policy analysis; qualitative research; participatory methodology; COXIB-selective inhibitors; new analgesics; policy recommendations; prescribing patterns; prescriptions; drug side effects; target populations; Dutch Health Care Insurance Board; HCIB; healthcare policy; healthcare insurance; The Netherlands.

DOI: 10.1504/IJHTM.2009.030692

International Journal of Healthcare Technology and Management, 2009 Vol.10 No.6, pp.361 - 377

Published online: 30 Dec 2009 *

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