WHAT RESEARCH SHOULD BE UNDERTAKEN TO SUPPORT DECISIONS REGARDING THE VALUE OF CURING OR ERADICATING DISEASE?
Author(s)
Carleigh B Krubiner, PhD, Johns Hopkins University, Baltimore, USA; Mark Sculpher, PhD, University of York, York, UK
Presentation Documents
ISSUE: Many health care interventions are focused on reducing the impact of a disease on individuals’ health. Methods of health technology assessment and economic evaluation are widely used support health systems’ decisions regarding the funding of such interventions. There is now a prospect of medical technologies curing disease, for example gene therapy for diseases such as haemophilia, and innovative approaches that may remove HIV in treated patients. Eradicating further tropical infectious diseases, such as visceral leishmaniasis, is also a prospect. Given the likely high cost of such interventions, appropriate research methods to support funding decisions will be important. But are current methods fit for purpose when major step-changes in health improvement are feasible? Furthermore, how should improvements in other aspects of wellbeing associated with cure be assessed when evaluating the value for money of these interventions against lower cost disease management options?
OVERVIEW: There are several ways in which standard economic evaluation may fall short in evaluating interventions with the prospect of curing or eradicating disease. These include the assumption of a linear relationship between gains in health and its value, a failure to recognize the importance of the burden of disease in assessing value and, in the case of disease eradication, not considering the value to future generations. Members of the panel will take different perspectives on appropriate methods in this context. Watkins will moderate and set the scene in terms of the characteristics of research to support payers’ decisions. Sculpher will argue that, when appropriately implemented, existing methods are entirely suitable for these interventions. Krubiner will present a range of ethical considerations that highlight the limitations of existing methods. Pearson will suggest an approach whereby the pricing of cures can be adjusted in a systematic fashion to allow innovators and society to share fairly in potential large downstream cost offsets. Organized by the ISPOR Health Technology Assessment (HTA) Council
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Code
IP12
Topic
Epidemiology & Public Health, Health Technology Assessment