The Role of the Expected Value of Individualized Care in Cost-Effectiveness Analyses and Decision Making

Jan 1, 2012, 00:00
10.1016/j.jval.2011.07.015
https://www.valueinhealthjournal.com/article/S1098-3015(11)03521-2/fulltext
Title : The Role of the Expected Value of Individualized Care in Cost-Effectiveness Analyses and Decision Making
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(11)03521-2&doi=10.1016/j.jval.2011.07.015
First page : 13
Section Title : Economic Evaluation
Open access? : No
Section Order : 5

Objective

To explore the feasibility and potential role of the expected value of individualized care (EVIC) framework.

Methods

The EVIC quantifies how much benefits are forgone when a treatment decision is based on the best-expected outcomes in the population rather than in the individual patient. We have reviewed which types of patient-level attributes contribute to the EVIC and how they affect the interpretation of the outcomes. In addition, we have applied the EVIC framework to the outcomes of a microsimulation-based cost-effectiveness analysis for glaucoma treatment.

Results

For EVIC outcomes to inform decisions about clinical practice, we need to calculate the parameter-specific EVIC of known or knowable patient-level attributes and compare it with the real costs of implementing individualized care. In the case study, the total EVIC was €580 per patient, but patient-level attributes known at treatment decision had minimal impact. A subgroup policy based on individual disease progression could be worthwhile if a predictive test for glaucoma progression could be developed and implemented for less than €130 per patient.

Conclusions

The EVIC framework is feasible in cost-effectiveness analyses and can be informative for decision making. The EVIC outcomes are particularly informative when they are (close to) zero. When the EVIC has a high value, implications depend on the type of patient-level attribute. EVIC can be a useful tool to identify opportunities to improve efficiency in health care by individualization of care and to quantify the maximal investment opportunities for implementing subgroup policy.

Categories :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Personalized & Precision Medicine
  • Specialized Treatment Areas
  • Value of Information
Tags :
  • expected value of individualized care
  • glaucoma
  • heterogeneity
  • personalized medicine
  • value of information
Regions :
  • Global
ViH Article Tags :