What Are the Biggest Value Drivers? A Comparison of the Relative Impacts of Six Novel Value Elements on Value Estimates Across Twelve Treatments Through Generalized Cost-Effectiveness Analyses
Author(s)
Richard Xie, PhD1, Peter Rubin, MBA2, Peter Kolchinsky, PhD3, Jeff Sullivan, MS4.
1RA Capital Management, Newton, MA, USA, 2NPLB, Chevy Chase, MD, USA, 3RA Capital Management, Boston, MA, USA, 4EntityRisk, Inc, Dedham, MA, USA.
1RA Capital Management, Newton, MA, USA, 2NPLB, Chevy Chase, MD, USA, 3RA Capital Management, Boston, MA, USA, 4EntityRisk, Inc, Dedham, MA, USA.
OBJECTIVES: Generalized Cost-Effectiveness Analysis (GCEA) has been proposed as a more comprehensive method to estimate the societal value of innovative treatments. This study applied GCEA to assess the value of innovative therapies, and to examine the relative impacts of six value elements on value estimates and their variations by treatment and therapeutic area (TA).
METHODS: Twelve drugs in 4 TAs were selected based on budgetary and policy impacts, as well as the availability of traditional cost-effectiveness analysis (TCEA) models in the Tufts CEA Registry or the Institute for Clinical and Economic Review’s final assessments. We replicated TCEAs and adapted them into GCEAs by incorporating six novel value elements. First, three risk-related elements were modeled using the generalized risk-adjusted cost-effectiveness analysis (GRACE) method. We then adjusted for two dynamics-related value elements. Finally, productivity impacts were incorporated. At each step, we calculated the incremental impacts of novel value elements on value-based prices (VBP). We then summarized the average impacts, and examined the variations across treatments and TAs.
RESULTS: GCEA-derived VBPs were, on average, 4.68 times those from TCEAs. Risk-related elements contributed to an average of 3.13% of the added value, while dynamics-related elements contributed 73.17% and productivity 23.70%. Dynamic-related elements were the primary value drivers in 9 treatments, and productivity in the remaining three. A comparison across TAs revealed that risk-related elements and dynamics-related elements had larger impacts in the “other” category, while productivity was most impactful in oncology.
CONCLUSIONS: GCEAs likely offer more comprehensive estimates of societal value. Failing to capture these novel elements in decision-making might deprioritize drug therapies relative to healthcare services (e.g., services) that do not go generic or have significant impacts on productivity. Our GCEA models incorporated only a subset of the novel elements, future research should implement more comprehensive GCEA models to explore the relative impacts of additional value elements.
METHODS: Twelve drugs in 4 TAs were selected based on budgetary and policy impacts, as well as the availability of traditional cost-effectiveness analysis (TCEA) models in the Tufts CEA Registry or the Institute for Clinical and Economic Review’s final assessments. We replicated TCEAs and adapted them into GCEAs by incorporating six novel value elements. First, three risk-related elements were modeled using the generalized risk-adjusted cost-effectiveness analysis (GRACE) method. We then adjusted for two dynamics-related value elements. Finally, productivity impacts were incorporated. At each step, we calculated the incremental impacts of novel value elements on value-based prices (VBP). We then summarized the average impacts, and examined the variations across treatments and TAs.
RESULTS: GCEA-derived VBPs were, on average, 4.68 times those from TCEAs. Risk-related elements contributed to an average of 3.13% of the added value, while dynamics-related elements contributed 73.17% and productivity 23.70%. Dynamic-related elements were the primary value drivers in 9 treatments, and productivity in the remaining three. A comparison across TAs revealed that risk-related elements and dynamics-related elements had larger impacts in the “other” category, while productivity was most impactful in oncology.
CONCLUSIONS: GCEAs likely offer more comprehensive estimates of societal value. Failing to capture these novel elements in decision-making might deprioritize drug therapies relative to healthcare services (e.g., services) that do not go generic or have significant impacts on productivity. Our GCEA models incorporated only a subset of the novel elements, future research should implement more comprehensive GCEA models to explore the relative impacts of additional value elements.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE751
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Oncology, Rare & Orphan Diseases