OBJECTIVES: To evaluate the effectiveness and adaptability of Structured Expert Elicitation (SEE) in guiding healthcare decision-making, particularly for drug pricing and reimbursement within the framework of the Inflation Reduction Act (IRA). The study aims to refine SEE methodologies to better align with the IRA's emphasis on cost-effectiveness and value in healthcare.

METHODS: The study involved a critical analysis of existing SEE methodologies in healthcare settings, focusing on areas with limited empirical data. This included a review of case studies demonstrating the application of SEE in healthcare decision-making, and an assessment of methodological enhancements to address the integration of diverse expert opinions and ensuring robustness within the IRA’s regulatory environment.

RESULTS: Findings highlight that existing SEE methodologies (either fixed interval or variable interval) can be adapted to better meet the requirements of the IRA, particularly in scenarios with scarce data. The effectiveness of virtual elicitation platforms was noted in facilitating broader expert participation and in managing logistical challenges. While technological enhancements show promise, the focus remains on refining traditional SEE methods to ensure more accurate, unbiased expert judgments that align with the IRA's cost containment and value-based goals.

CONCLUSIONS: The study underscores the potential of refined SEE methodologies as essential tools in the evaluative processes of the IRA, particularly in drug pricing and healthcare decision-making. A well-executed SEE study can help establish the limits of uncertainty for key inputs of economic models and gather qualitative information to support the narrative about a product's safety, value, or pricing. Enhancements in SEE methods, focusing on accuracy and unbiased expert input, are crucial for aligning with the IRA’s directives on cost-effectiveness and value-based healthcare. This research paves the way for more informed, data-driven, and equitable healthcare policy decisions in the new era of the IRA.