A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients.

[1]  Anirban Basu,et al.  Approaches to Aggregation and Decision Making—A Health Economics Approach: An ISPOR Special Task Force Report [5]☆ , 2018, Value in Health.

[2]  Louis P Garrison,et al.  A Health Economics Approach to US Value Assessment Frameworks-Introduction: An ISPOR Special Task Force Report [1]. , 2018, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[3]  Scott D Ramsey,et al.  Review of Recent US Value Frameworks-A Health Economics Approach: An ISPOR Special Task Force Report [6]. , 2018, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[4]  Louis P Garrison,et al.  Defining Elements of Value in Health Care-A Health Economics Approach: An ISPOR Special Task Force Report [3]. , 2018, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[5]  Patricia M Danzon,et al.  Objectives, Budgets, Thresholds, and Opportunity Costs-A Health Economics Approach: An ISPOR Special Task Force Report [4]. , 2018, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[6]  Louis P Garrison,et al.  An Overview of Value, Perspective, and Decision Context-A Health Economics Approach: An ISPOR Special Task Force Report [2]. , 2018, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.