Health Policy 92 (2009) 124–132 Contents lists available at ScienceDirect Health Policy journal homepage: www.elsevier.com/locate/healthpol Overcoming barriers to priority setting using interdisciplinary methods Stuart Peacock a,b,* , Craig Mitton c,d , Angela Bate e , Bonnie McCoy f , Cam Donaldson e,g a Centre for Health Economics in Cancer, British Columbia Cancer Agency, Canada b School of Population and Public Health, University of British Columbia, Canada c Faculty of Health and Social Development, University of British Columbia Okanagan, Canada d Child and Family Research Institute of British Columbia, Canada e Institute of Health and Society, Newcastle University, UK f Research, Administration and Development, Fraser Health Authority, Canada g Newcastle University Business School, UK article info Keywords: Priority setting Program budgeting and marginal analysis Ethics Participatory action research Accountability for reasonableness Multi-criteria decision analysis abstract Ten years ago, Holm’s highly influential paper “Goodbye to the simple solutions: the second phase of priority setting” was published [Holm S. Goodbye to the simple solutions: the second phase of priority setting in health care. British Medical Journal 1998;317:1000–7]. Whilst attending the 2nd International Conference on Priorities in Health Care in London, Holm argued that the search for a rational set of decision-making rules was no longer adequate. Instead, the priority setting process itself was now thought to be more complex. Ten years later, the Conference returns to the UK for the first time, and it is timely to describe some new tools intended to assist both researchers and decision-makers seeking to develop both rational and fair and legitimate priority setting processes. In this paper we argue that to do so, researchers and decision-makers need to adopt an interdisciplinary and collaborative approach to priority setting. We focus on program budgeting and marginal analysis (PBMA) and bring together three hitherto separate interdisciplinary strands of the PBMA literature. Our aim is to assist researchers and decision-makers seeking to effectively develop and implement PBMA in practice. Specifically, we focus on the use of multi-criteria decision analysis, participatory action research, and accountability for reasonableness, drawn from the disciplines of decision analysis, sociology, and ethics respectively. © 2009 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Ten years ago, Holm’s highly influential paper “Good- bye to the simple solutions: the second phase of priority setting” was published [1]. Whilst attending the 2nd Inter- national Conference on Priorities in Health Care in London, Holm argued that the search for a rational set of decision- making rules was no longer adequate. Instead, the priority setting process itself was now thought to be more complex. * Corresponding author at: British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, Canada. Tel.: +1 604 675 8068; fax: +1 604 675 8180. E-mail address: speacock@bccrc.ca (S. Peacock). Ten years later, the Conference returns to the UK for the first time, and it is timely to describe some new tools intended to assist both researchers and decision-makers seeking to develop rational, fair and legitimate priority setting pro- cesses. In this paper we argue that to do so, researchers and decision-makers need to adopt an interdisciplinary and collaborative approach to priority setting. We focus on program budgeting and marginal analysis (PBMA) and bring together three hitherto separate interdis- ciplinary strands of the PBMA literature. Our aim is to assist researchers and decision-makers seeking to effectively develop and implement PBMA in practice. We describe a new interdisciplinary framework for PBMA which is based on learning from real-world experience with health systems and a range of different academic disciplines. 0168-8510/$ – see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.healthpol.2009.02.006