Health Policy 69 (2004) 1–10 Setting priorities for research Rachael L. Fleurence * , David J. Torgerson Department of Health Sciences, Seebohm-Rowntree Building, Area 4, University of York, York YO10 5DQ, UK Received 30 April 2003; received in revised form 30 October 2003; accepted 5 November 2003 Abstract Setting priorities for research should be conducted in order to make the most efficient use of scarce resources. Yet the uptake in practice of such methods by researchers and commissioners of research alike has been slow, in part because the methodologies available to do so have not been widely disseminated. This paper argues that an appropriate priority-setting methodology should meet the objectives of the health system, that is to provide the most health benefits to the population that it serves within the budget constraint and while respecting equity considerations. A condition for these criteria to be met is to construct and operationalise an appropriate definition of the value of research. Five different ways that have been used in practice to value research and set priorities were reviewed. Shortcomings in the ways research is valued make it unlikely that the application of subjective methods, burden of disease methods, and clinical variations and payback methods meet the objectives of the health system. Using the fifth method, value of information, priority-setting can meet the objectives of the health system because it expresses the value of research using the same overall cost-effectiveness framework that is employed for decisions on service provision. However, this method still requires further work to evaluate how research outcomes can then be communicated to clinical practitioners and how practitioners can be encouraged to implement them. © 2003 Elsevier Ireland Ltd. All rights reserved. Keywords: Priority-setting; Health research; Economics 1. Introduction The reform of clinical research and development announced by the UK government in 2000 reflects the increasing awareness of the need to set priorities for research spending. Establishing priority-setting is complex in part because of the number of stakehold- ers that are involved in the process. Over £1500 mil- lion were spent in 2000 on research and development by the non-profit sector in the UK, with the Depart- * Corresponding author. Tel.: +44-1904-321-340; fax: +44-1904-321-383. E-mail address: rfleurence@yahoo.co.uk (R.L. Fleurence). ment of Health’s contribution at £500 million and the remainder being shared between the voluntary sec- tor and large medical research charities, such as the Medical Research Council. The private sector spent £3000 million in 2000. Reforms aim to coordinate research activities between these different partners, thereby allowing an overall strategy in research and development to be followed [1]. The lack of consensus on an appropriate method- ology for priority-setting is also impeding progress [2]. Until a clearer knowledge and understanding of such method emerges, it is unrealistic to expect either researchers to include appropriate priority-setting in- formation in their funding proposals, or commission- 0168-8510/$ – see front matter © 2003 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.healthpol.2003.11.002