INTRODUCTION: Multiple Criteria Decision Analysis (MCDA) is increasingly used in health
care mainly because it moves decision-making from ad hoc to an evidence-based and
comprehensive process. Developing countries with more restricted financial and human
research capacities, however, should consider their own methods of MCDA development
and implementation. Areas covered: An MCDA framework to improve procurement decisions
of off-patent pharmaceuticals was developed for developing countries and adapted to
Indonesia, Kazakhstan and Vietnam during three policy workshops. Based on the experience
of these workshops and one joint workshop with international experts and decision
makers from multiple developing countries, general recommendations were formulated
on how to implement MCDA specifically in developing countries. We provide 17 practical
MCDA implementation recommendations in four major areas, including (1) MCDA objectives;
(2) technical considerations of MCDA tool; (3) development and customization of MCDA
tool and (4) policy implementation of MCDA in decision-making. Expert commentary:
These practical MCDA recommendations for developing countries contribute to feasible,
transparent, stepwise, iterative and standardized decision-making in health care.
