EVIDENCE READINESS FOR HEOR-ORIENTED VALUE ASSESSMENT IN EUROPEAN VBHC INITIATIVES: A CROSS-CASE STUDY OF 40 EAVH-MAPPED CASES
Author(s)
Martina PIPOLI, MA1, Michele Calabrò, Msc2, DR MARCOS Gallego Llorente, PhD3, Jan-Philipp Beck, MBA3, Josephine Mosset, MA4, Ber Oomen, RN5, Thomas Allvin, MSc6.
1University of Salento, Lecce, Italy, 2EUREGHA, Brussels, Belgium, 3Vintura BV, Utrecht, Netherlands, 4Cancer Patients Europe (CPE), Brussels, Belgium, 5European Specialist Nurses Organisations (ESNO), Arnhem, Netherlands, 6European Federation of Pharmaceutical Industries and Associations (EFPIA), BRUSSELS, Belgium.
1University of Salento, Lecce, Italy, 2EUREGHA, Brussels, Belgium, 3Vintura BV, Utrecht, Netherlands, 4Cancer Patients Europe (CPE), Brussels, Belgium, 5European Specialist Nurses Organisations (ESNO), Arnhem, Netherlands, 6European Federation of Pharmaceutical Industries and Associations (EFPIA), BRUSSELS, Belgium.
OBJECTIVES: Value-based healthcare (VBHC) requires patient-relevant outcomes to be interpreted alongside resources used to achieve them. We define HEOR readiness as the extent to which initiatives document integrated, decision-oriented evidence suitable for value assessment, scale-up, procurement, reimbursement, or policy. We evaluated the maturity, completeness, and robustness of such evidence across European VBHC initiatives mapped by the European Alliance for Value in Healthcare (EAVH).
METHODS: Forty European initiatives underwent structured cross-case coding. We defined a structural patient-centred value package as documented co-presence of formal patient-reported outcome/experience measurement (PROM/PREM), cost/resource-use metrics, and a feedback loop linking evidence to improvement. An observed patient-centred value package additionally required observed cost/resource-use results. Analyses included an evidence maturity cascade, Wilson 95% confidence intervals (CIs), sensitivity analyses, missingness and documentation-completeness assessment, Fisher's exact tests, and exploratory Firth logistic regression.
RESULTS: Formal PROM/PREM measurement was documented in 18/40 initiatives (45.0%), cost/resource-use metrics in 16/40 (40.0%), and observed cost/resource-use results in 9/40 (22.5%). Nine initiatives met the structural package definition (22.5%; 95% CI, 12.3%-37.5%) and four met the observed definition (10.0%; 95% CI, 4.0%-23.1%). Cost/resource information was not reported or incomplete in 26/40 initiatives (65.0%). Structural packages were more frequent in mature/network-system implementations (9/21 versus 0/19; Fisher p=0.0014) and initiatives with documented data infrastructure/dashboards (9/27 versus 0/13; p=0.0195). In exploratory Firth regression, maturity was associated with structural package identification (odds ratio 29.64; 95% CI, 3.25-3948.12; p=0.0008).
CONCLUSIONS: European VBHC initiatives showed substantial improvement and monitoring activity, but HEOR readiness was limited by three gaps: a measurement gap, with PROM/PREM and cost/resource metrics not consistently collected together; an operational gap, with data not always feeding feedback loops or decisions; and an evidence translation gap, with evidence not consistently ready for scale-up, procurement, reimbursement, or policy. Future research should develop and validate a maturity-based HEOR readiness checklist to operationalise these requirements.
METHODS: Forty European initiatives underwent structured cross-case coding. We defined a structural patient-centred value package as documented co-presence of formal patient-reported outcome/experience measurement (PROM/PREM), cost/resource-use metrics, and a feedback loop linking evidence to improvement. An observed patient-centred value package additionally required observed cost/resource-use results. Analyses included an evidence maturity cascade, Wilson 95% confidence intervals (CIs), sensitivity analyses, missingness and documentation-completeness assessment, Fisher's exact tests, and exploratory Firth logistic regression.
RESULTS: Formal PROM/PREM measurement was documented in 18/40 initiatives (45.0%), cost/resource-use metrics in 16/40 (40.0%), and observed cost/resource-use results in 9/40 (22.5%). Nine initiatives met the structural package definition (22.5%; 95% CI, 12.3%-37.5%) and four met the observed definition (10.0%; 95% CI, 4.0%-23.1%). Cost/resource information was not reported or incomplete in 26/40 initiatives (65.0%). Structural packages were more frequent in mature/network-system implementations (9/21 versus 0/19; Fisher p=0.0014) and initiatives with documented data infrastructure/dashboards (9/27 versus 0/13; p=0.0195). In exploratory Firth regression, maturity was associated with structural package identification (odds ratio 29.64; 95% CI, 3.25-3948.12; p=0.0008).
CONCLUSIONS: European VBHC initiatives showed substantial improvement and monitoring activity, but HEOR readiness was limited by three gaps: a measurement gap, with PROM/PREM and cost/resource metrics not consistently collected together; an operational gap, with data not always feeding feedback loops or decisions; and an evidence translation gap, with evidence not consistently ready for scale-up, procurement, reimbursement, or policy. Future research should develop and validate a maturity-based HEOR readiness checklist to operationalise these requirements.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD74
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas