MOVING BEYOND THE QALY IN PATIENT-CENTERED VALUE FRAMEWORKS- BUT IN WHAT DIRECTION?

Author(s)

Nancy Devlin, PhD, Office of Health Economics, London, UK; F. Reed Johnson, PhD, Duke Clinical Research Institute, Durham, USA; Sachin Kamal-Bahl, PhD, Pfizer, Collegeville, USA; Shelby D. Reed, PhD, RPh, Duke University, Durham, USA

ISSUE: Most medical intervention value frameworks implicitly recognize that quality-adjusted life years, as conventionally applied in health technology assessments, do not incorporate important dimensions of value. Most value frameworks consider such factors as disease severity, availability of therapeutic options, treatment experience, and such indirect or downstream effects as work productivity and burden on family and informal caregivers, as well as clinician-reported and patient-reported outcomes. The multiple benefit categories included in value frameworks require assignment of weights or scores to obtain aggregate benefit measures for comparisons among intervention alternatives. Some value framework advocates suggest generation of weights through discussion and deliberation among clinicians and other stakeholders, while others advocate systematic quantitative measurement using stated-preference methods in samples of patients. The potential advantages and disadvantages of these approaches will be debated. OVERVIEW: Dr. Reed will serve as moderator. She will review therapeutic benefit categories included in various value frameworks and how benefit levels are scored or weighted. Panelists will provide differing perspectives on how to obtain patient-centered value weights for aggregating disparate benefit categories. Dr. Devlin will discuss how multi-criteria decision analysis to structure discussion and deliberation among various stakeholder representatives would ensure patients’ best interests are served by basing weights on well-informed professional and lay judgments. Dr. Johnson will discuss how stated-preference methods would ensure patients’ best interests are served by basing weights on patients’ own assessments of value. Dr. Kamal-Bahl will present an industry perspective on the two approaches, including their possible effects on product development and regulatory reviews. The panel will identify scenarios in which the two approaches could be more or less appropriate and scenarios in which the two approaches are more or less likely to lead to divergent assessments. The panel also will comment on the extent to which existing value frameworks reflect a patient-centric approach to benefit valuation.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Code

IP10

Topic

Health Technology Assessment, Patient-Centered Research

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