Barriers to and facilitators of implementing the Lebanese Health economic evaluation guideline: an initial exploration

Objective: To identify the major barriers to and facilitators of implementing the Lebanese HealthEconomic Evaluation Guideline (LEEG) according to Lebanese stakeholders, supported by their insights.Methods: We conducted a survey asking 16 key stakeholders to rate LEEG’s importance, its necessity forLebanon, and its applicability in decision-making, and Likert scale questions to rate barriers andfacilitators. Following the survey, an individual face-to-face interview using open-ended questionswas arranged to validate the survey’s data, to collect further insights regarding LEEG’s implementationin Lebanon, and to identify relevant barriers and facilitators.Results: All participants considered LEEG to be very important for Lebanon. The majority considered itvery important for decision-making, while there was some disagreement on the applicability ofeconomic evaluation as a criterion for decision-making. The most important barriers were ‘lack ofpolitical willingness to adopt economic evaluation and use health technology assessment findings’and ‘the absence of policy networks.’ The most important facilitators were ‘the strong need toimplement national guidelines in Lebanon’ and ‘acceptability to payers.’Conclusion: We reported on important barriers to and facilitators of implementing LEEG related to thenational context and methodological concerns. This will pave the way for developing strategiesessential for effective implementation and, consequently, a better healthcare system, advancing pro-gress to universal health coverage