Approaches to Aggregation and Decision Making—A Health Economics Approach- An ISPOR Special Task Force Report [5]

Feb 1, 2018, 00:00 AM
10.1016/j.jval.2017.12.010
https://www.valueinhealthjournal.com/article/S1098-3015(17)33895-0/fulltext
Section Title : ISPOR Reports
Section Order : 5
First Page : 146

The fifth section of our Special Task Force report identifies and discusses two aggregation issues: 1) aggregation of cost and benefit information across individuals to a population level for benefit plan decision making and 2) combining multiple elements of value into a single value metric for individuals. First, we argue that additional elements could be included in measures of value, but such elements have not generally been included in measures of quality-adjusted life-years. For example, we describe a recently developed extended cost-effectiveness analysis (ECEA) that provides a good example of how to use a broader concept of utility. ECEA adds two features—measures of financial risk protection and income distributional consequences. We then discuss a further option for expanding this approach—augmented CEA, which can introduce many value measures. Neither of these approaches, however, provide a comprehensive measure of value. To resolve this issue, we review a technique called multicriteria decision analysis that can provide a comprehensive measure of value. We then discuss budget-setting and prioritization using multicriteria decision analysis, issues not yet fully resolved. Next, we discuss deliberative processes, which represent another important approach for population- or plan-level decisions used by many health technology assessment bodies. These use quantitative information on CEA and other elements, but the group decisions are reached by a deliberative voting process. Finally, we briefly discuss the use of stated preference methods for developing “hedonic” value frameworks, and conclude with some recommendations in this area.

https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(17)33895-0&doi=10.1016/j.jval.2017.12.010
HEOR Topics :
Tags :
  • aggregation
  • cost-effectiveness
  • equity
  • multi-dimensioned benefits
Regions :