**The Matrix**

This month, PHARMAC, New Zealand's medicine's funding agency, released a discussion document as part of a review of its decision criteria. In the document, you'll find something purporting to be a *proposed decision-making matrix*:

Got that? Didn't think so. With the best will in the world, this isn't a matrix. A decision matrix gives you a value for the intersection of two criteria, and - crucially - it generally helps you make a decision. This doesn't do either of those things, though it does line the relevant factors up in a rectangle.

**Let's remix the matrix**

If we look at the diagram, we really see that Pharmac is showing us two sorts of criteria. One is how well a proposed treatment meets patient need. The other is cost. And each of these can be high - a good match to patient need, and a high cost - or low.

Now, we can sort the factors on the original diagram into our cost/benefit matrix:

This gives us a good idea of how PHARMAC might frame its decision-making for any given case:

You could go a step further, weighting the factors and grading each funding proposal against them. That would probably introduce pseudoaccuracy into a process that's intended to have a little wiggle room. But remixing the matrix this way frames the beginning of your deliberations: it gives you a place to start. You can then go through the various factors in detail, determine the ultimate point on the matrix - and reach your final funding decision.