An application of analytic network process model in supporting decision making to address pharmaceutical shortage

Background: The present study aimed to develop an Analytic Network Process (ANP) model to assist policymakers in identifying and prioritizing allocation indicators, which are being used or should be used to distribute drugs in short supply among different provinces. Methods: The model encompasses the interactions between various indicators and efficiency, equity, and effectiveness paradigms. Accordingly, a set of clusters and elements, which were associated with the allocation of drugs in short supply in Iran's pharmaceutical system, were detected to develop the model and were then compared in pairs in terms of a specified factor to show the priorities. Results: Equity had the highest priority (0.459) following by Efficiency (0.37), and Effectiveness (0.171). The 4 most important allocation indicator were "number of prescriptions"(0.26) and "total bed occupancy rate"(0.19) related to equity, "total population"(0.21) in efficiency and "the burden of rare and incurable disease"(0.07) in effectiveness paradigm. Conclusions: The capability to overcome inefficient resource allocation patterns caused by both oversupply and undersupply derived from historic resource allocation may be highly limited in the absence of the need indicators. The quality of the decision is related to a careful balancing act of the three paradigms which represents roughly the triple aim of public healthcare systems: clinical improvement (effectiveness), population health improvement (equity and access), and reducing cost (economic aspects -efficiency). © 2020 The Author(s)