Multistakeholder Survey on Communication of Uncertainties in Cost-Effectiveness Analysis by the Institute of Clinical and Economic Review
Author(s)
Jan-Willem Versteeg, MSc, PharmD1, Christine Leopold, PhD1, Aukje Mantel-Teeuwisse, PhD1, Wim Goettsch, MSc, PhD2, Dan Ollendorf, MPH, PhD3.
1Utrecht University, Utrecht, Netherlands, 2Zorginstituut Nederland, Diemen, Netherlands, 3Institute for Clinical & Economic Review, Boston, MA, USA.
1Utrecht University, Utrecht, Netherlands, 2Zorginstituut Nederland, Diemen, Netherlands, 3Institute for Clinical & Economic Review, Boston, MA, USA.
OBJECTIVES: The Institute for Clinical and Economic Review (ICER) performs cost-effectiveness analysis (CEA) to inform reimbursement policy. Uncertainty is an inevitable consequence of CEA, and the implications of these uncertainties on the analysis conclusions can be significant. Therefore, clear and understandable communication of uncertainty, its impact on findings, and the conduct of sensitivity analyses to further explore uncertainty are critical. This study aims to analyze how ICER’s communications regarding CEA uncertainty are perceived by stakeholders and any recommendations for improvement that are suggested.
METHODS: We conducted a structured online survey among ICER’s stakeholders. The survey was open from March 14 to April 25, 2025. The survey consisted of both categorical questions based on Likert scale levels and open-ended questions. The survey focused on four distinct topics: CEA base-case results and sensitivity analyses; structural and parametrical uncertainty; understanding different sections of an ICER report; and understanding ICER communications outside of reports. Categorical questions were analyzed using Qualtrics® software, and open-ended questions were coded and analyzed using Excel.
RESULTS: Through a call to participate published in ICER’s newsletters and LinkedIn a total of 34 completed survey responses were obtained, representing a diverse group of ICER stakeholders. For all four topics, a majority of respondents perceived ICER’s communication on uncertainty as clear and understandable. Improvements were suggested on communication regarding the structural and parametrical uncertainties underlying the analysis, as well as the summary and price benchmarking report sections. Recurrent themes in the answers to the open-ended questions were a call for more robust scenario analyses, more emphasis on uncertainty in the summary section, and the need for more discussion on the justification and impact of structural and parametrical assumptions.
CONCLUSIONS: Overall, stakeholders perceived ICER’s communication on uncertainty in the CEA as clear and understandable while providing important insights on how communication of such uncertainty could be improved.
METHODS: We conducted a structured online survey among ICER’s stakeholders. The survey was open from March 14 to April 25, 2025. The survey consisted of both categorical questions based on Likert scale levels and open-ended questions. The survey focused on four distinct topics: CEA base-case results and sensitivity analyses; structural and parametrical uncertainty; understanding different sections of an ICER report; and understanding ICER communications outside of reports. Categorical questions were analyzed using Qualtrics® software, and open-ended questions were coded and analyzed using Excel.
RESULTS: Through a call to participate published in ICER’s newsletters and LinkedIn a total of 34 completed survey responses were obtained, representing a diverse group of ICER stakeholders. For all four topics, a majority of respondents perceived ICER’s communication on uncertainty as clear and understandable. Improvements were suggested on communication regarding the structural and parametrical uncertainties underlying the analysis, as well as the summary and price benchmarking report sections. Recurrent themes in the answers to the open-ended questions were a call for more robust scenario analyses, more emphasis on uncertainty in the summary section, and the need for more discussion on the justification and impact of structural and parametrical assumptions.
CONCLUSIONS: Overall, stakeholders perceived ICER’s communication on uncertainty in the CEA as clear and understandable while providing important insights on how communication of such uncertainty could be improved.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE593
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas