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From the same journal

From the same journal

A Health Economics Approach to US Value Assessment Frameworks - Summary and Recommendations of the ISPOR Special Task Force Report [7]

Research output: Contribution to journalArticle

Author(s)

  • Louis R. Garrison
  • P. Neumann
  • R. Willke
  • A. Basu
  • P. Danzon
  • J. Doshi
  • M.F. Drummond
  • D. Lakdawalla
  • Markus Pauly
  • C. Phelps
  • S. Ramsey
  • A. Towse
  • M. Weinstein

Department/unit(s)

Publication details

JournalValue in Health
DateSubmitted - 13 Dec 2017
DateAccepted/In press - 3 Jan 2018
DatePublished (current) - 23 Feb 2018
Issue number2
Volume21
Number of pages5
Pages (from-to)161-165
Original languageEnglish

Abstract

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an “augmented” costeffectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a costeffectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients.

Bibliographical note

© 2018, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

    Research areas

  • augmented cost-effectiveness analysis, benefit-cost analysis, multi-criteria decision analysis, value frameworks

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