Presentation (CTI)

OBJECTIVES: In 2018, an ISPOR Special Task Force proposed novel elements of value (NEVs) to expand the concept of value in health care and inspire new cost-effectiveness analysis (CEA) research. A prior analysis (Crummer et al., 2022) reviewed consideration of NEVs in CEAs published between 2016 and 2020. This study updates that work by examining how NEVs appear in more recent CEA literature, distinguishing between qualitative discussion and quantitative incorporation into analyses.
METHODS: We used the Tufts CEA Registry to conduct a structured review of CEAs published between 2021 and 2024. Articles were screened using a Python-based algorithm, aligned with the search strategy from Crummer (2022) to identify potential references to NEVs. Full texts were then manually reviewed to assess whether and how NEVs were considered. Results from this period were combined with those reported by Crummer.
RESULTS: Among 7,009 articles, 142 (2.03%) considered at least one NEV, of which 37 (0.53%) quantitatively incorporated an NEV into the analysis. Severity of disease was the most frequently addressed NEV (discussed in 64 studies, 11 of which quantified it), followed by insurance value (18 discussed, 4 quantified). Adherence-improving factors were mentioned in 11 studies and quantified in 9, while genericization was mentioned in 8 studies and quantified in 4. Real option value was quantified in a total of 2 studies, and fear of contagion was mentioned in 2 but not quantified. Scientific spillovers (5 discussed) were not quantified. Equity was discussed in 12 studies and quantified in 7. Neither value of hope nor reduction in uncertainty was addressed in any CEA.
CONCLUSIONS: Incorporation of NEVs into CEA remains limited. These findings highlight persistent methodological barriers and data limitations, as well as the need for clearer guidance and standardized approaches to support their inclusion in economic evaluations.