Presentation (CTI)

OBJECTIVES: Traditional health economic approaches require a trade-off between operational simplicity and comprehensive value assessment. This study introduces the Value-Adjusted Cost per Therapeutic Success (VACTS), a pragmatic value-based economic architecture designed to bridge the gap between cost-per-responder and cost-utility approaches by integrating real-world treatment costs, clinician-reported outcomes, and patient-reported outcomes into local healthcare decision making.
METHODS: A conceptual methodological architecture was developed based on principles of Value-Based Healthcare, patient-centered outcomes, and real-world evidence. The framework is represented by the relationship VACTS = Adjusted Annual Treatment Cost / Therapeutic Success Index (ISTC), where the ISTC integrates disease-specific clinician-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs). The architecture was intentionally designed to accommodate different levels of evidence availability, enabling implementation using local routinely collected data or evidence derived from randomized clinical trials, real-world studies, systematic reviews, indirect treatment comparisons, and other evidence synthesis methods. Real-world treatment costs incorporate therapeutic modifications that substantially influence healthcare resource utilization beyond label-based assumptions.
RESULTS: The proposed architecture integrates three complementary perspectives within a single economic framework: real-world treatment costs, clinician-reported outcomes, and patient-reported outcomes. VACTS bridges the operational simplicity of cost per responder and the methodological rigor of cost-utility approaches while maintaining flexibility for local adaptation and sensitivity analyses. The framework is intended to improve recognition of scenarios in which marginal clinical improvements require disproportionately greater economic investment, a relationship that may not be fully reflected by conventional responder-based metrics.
CONCLUSIONS: VACTS represents a pragmatic, scalable, and evidence-adaptive economic architecture for value-based health technology assessment. Rather than replacing established economic evaluation methods, it complements existing approaches by providing an objective, flexible, and rapidly applicable framework for local decision making when comprehensive utility-based models are not feasible, while systematically incorporating both clinician and patient perspectives.