How Can Grace and Other Novel Methods Estimate ISPOR Value Flower Components? A User Guide to Generalized Cost Effectiveness Analysis (GCEA)


Discussion Leader: Jason Shafrin, PhD, Center for Healthcare Economics and Policy, FTI Consulting, Los Angeles, CA, USA
Discussants: Lotte Steuten, PhD, Office of Health Economics, London, UK; Melanie D. Whittington, PhD, MS, Tufts Medical Center (CEVR), Boston, MA, USA; Lou Garrison, PhD, The Comparative Health Outcomes, Policy, and Economics Institute, School of Pharmacy, University of Washington, Seattle, WA, USA

Presentation Documents


The ISPOR Value Flower continues to have a major impact on the assessment of value for healthcare technologies. The petals within the ISPOR Value Flower have become a mainstay in the health economics and outcomes research community, yet the novel methods to quantify each petal are not regularly implemented in value assessment today. This workshop provides a user guide on the novel methods to incorporate the petals within value assessment using a framework referred to as generalized cost effectiveness analysis (GCEA).


The workshop will begin with an overview of the GCEA framework. Dr. Shafrin will describe how value petals within this framework correspond to four value assessment themes: uncertainty, dynamics, value based on beneficiary identity, and other factors. Dr. Steuten will next discuss how the UK has tried to address these issues using decision modifiers around disease severity and other factors. Then, Professor Towse will explain how Generalized Risk-Adjusted Cost Effectiveness (GRACE) can be incorporated into GCEA to vary treatment value depending on disease severity. Next, Dr. Whittington will explain how stacked cohort models can be used to estimate long-run pricing dynamics, by incorporating genericization and pricing trends over time to more accurately capture the opportunity costs of healthcare interventions. Finally, Dr. Garrison will provide considerations for estimating value from the societal perspective in general and—more specifically—best practices for quantifying real option value. All three Discussants will provide applied examples of these methodologies. By the end of the session, the audience will understand the GCEA framework, which petals correspond to which broader value themes, and the fundamental steps and relevant references for estimating key GCEA petals. Real-time polling will be used to assess the attendees’ knowledge of which petals map to which themes and the methodological step ordering for the key GCEA value petals presented.

Conference/Value in Health Info

2024-05, ISPOR 2024, Atlanta, GA, USA




Economic Evaluation

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on Update my browser now