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

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

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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.
Original languageEnglish
Pages (from-to)161-165
Number of pages5
JournalValue in Health
Issue number2
Publication statusPublished - 23 Feb 2018

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.


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

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