Author(s)
Schlander M1, Telser H2, Holm S3, Marshall DA4, Nord E5, Richardson J6, Garattini S7, Kolominsky-Rabas P8, Persson U9, Postma MJ10, Simoens S11, de Sola-Morales O12, Tolley K13, Toumi M14
1Institute for Innovation & Valuation in Health Care (InnoVal-HC), Wiesbaden, Germany, 2Polynomics AG, Olten, Switzerland, 3University of Manchester, Manchester, UK, 4Alberta Bone and Joint Health Institute, Calgary, AB, Canada, 5Norwegian Institute of Public Health, Oslo, Norway, 6Monash University, Clayton, Victoria, Australia, 7Mario Negri Institute for Pharmacological Research, Milano, Italy, 8Interdisciplinary Centre for Health Technology Assessment and Public Health (IZPH), Friedrich-Alexander-University of Erlangen-Nürnberg; National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’, Erlangen, Germany, 9The Swedish Institute for Health Economics (IHE), Lund, Sweden, 10University of Groningen, Groningen, The Netherlands, 11KU Leuven, Leuven, Belgium, 12Health Innovation Technology Transfer, Barcelona, Spain, 13Tolley Health Economics Ltd., Buxton, UK, 14University Claude Bernard Lyon 1, Lyon, France
Objectives: Unlike cost benefit analysis, cost effectiveness analysis (CEA) is restricted to length of life and health-related quality of life as integrated measures of benefit. Valuation is based on individual preferences for health states. Yet dimensions of social value may exceed those driven by (aggregated) individual preference satisfaction. Multi-criteria decision analysis (MCDA) and social cost value analysis (SCVA) were proposed as alternatives to the conventional logic. Both approaches need support by robust evidence on social preferences. Methods: A literature review identified empirical studies reporting health care resource allocation priorities. On this basis, the authors deliberated implications and ways forward. Results: The review revealed social preferences for health care resource allocation including, beyond economic efficiency, (a) preferences primarily related to the health state (severity of initial health state and urgency of an intervention); (b) social preferences related to patient attributes (such as younger age, parent and caregiver status, and non- smoker); (c) social preferences with regard to allocation rules and a dislike against all-or-nothing allocation decisions and against discrimination of certain patient groups – apparently related to rights-based reasoning, including a relatively minor role of treatment costs per patient. Limitations of the literature were identified to include heterogeneity of study designs, small size of many studies, and potential bias due to framing effects and unstable preferences in some surveys. Conclusions: The expert group agreed that a European Social Preference Measurement (ESPM) study should address the limitations above. The study will be conducted in two phases (pilot study in Switzerland before international roll-out), adhere to a discrete choice experiment design, and address how the public valuates key attributes of health care interventions, explore international similarities and differences with respect to the weighting of the attributes and their interaction, and assess robustness to framing effects. Design of the study will be presented for discussion.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHP389
Topic
Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Confounding, Selection Bias Correction, Causal Inference
Disease
Multiple Diseases