Presentation (CTI)

OBJECTIVES: Accurately capturing the full impact of novel interventions in economic evaluations is important to reflect the true value of therapeutic advances. In 2018, ISPOR introduced the Value Flower, outlining broader value elements beyond those which are typically included in conventional cost-effectiveness analyses (CEAs). Despite recognition of the importance of these broader impacts, it remains unclear how consistently they are operationalized in CEAs and Health Technology Assessment (HTA) processes. The objective is to explore the inclusion of broader value elements from the ISPOR Value Flower in economic evaluations.
METHODS: A focused review was conducted to assess the empirical application of broader value elements in economic evaluations. We searched the Tufts CEA Registry from 2021 to 2025 using key terms representing the 10 broader value elements in the ISPOR Value Flower. The two core value elements were not included in this review. Titles and abstracts were screened to determine whether ISPOR Value Flower elements were included.
RESULTS: We identified 329 CEAs. Of these, 15 CEAs included elements from the 10 Value Flower elements assessed; 10 included adherence-improving factors and productivity. Only 9 CEAs reported novel broader value elements, including spillover effects, environmental impact, educational gains, health equity, insurance value, value of hope, and option value. Four CEAs quantified productivity and at least one other novel broader value element. Reporting of broader value elements was inconsistent. Where value elements were quantified, methodological variability and uncertainty were observed, highlighting a lack of standardized approach for including broader value elements.
CONCLUSIONS: Our findings highlight that very limited published CEAs incorporate broader value elements, indicating they are rarely implemented in practice. There is a clear need for practical guidance on robustly quantifying these elements, to facilitate HTA and evidence-based decision-making.