To drive true health care reform in the United States, value assessments of health care treatments must be based on strong methods and patient preferences: That’s the message of a recent commentary penned by PhRMA Foundation President Eileen Cannon for Value & Outcomes Spotlight – a publication of ISPOR.
According to Cannon, value varies by perspective. That means that in the quest for accurate value assessment, concepts such as “hope” — which is a value-element of importance for most patients – should be considered.
Cannon suggests that improving value assessment methodology to incorporate these more nuanced metrics is an urgent need, and that moving beyond traditional measurements of value will help the health system respond.
One of these commonly used measurements, which is due for reassessment, is the Quality Adjusted Life Year, or QALY. While frequently used, the QALY has been criticized for several potential limitations. Among them: QALY calculations often assume individual patients are risk-neutral, and they may not indicate all potential impacts of health care interventions, e.g., well-being.
Creating new, more accurate value assessments – which go beyond the limitations of metrics such as the QALY – will require better measurement of concepts such as hope, according to Cannon.
“Researchers have substantiated the significance that patients attach to hope, but the high value people assign to this outcome is frequently excluded in cost-effectiveness analyses,” she writes.
“While moving away from traditional measures of costs and benefits may seem daunting, painting a more holistic picture of value that captures the heterogeneity of patient preferences will ensure value-based care truly reflects the significance of life-saving and life-improving treatments to patients, providers, payers, and the greater public,” Cannon writes. “Promoting the development of new and novel methods that address some of the widely acknowledged shortcomings of traditional value assessments will help direct scarce resources to the most effective and promising therapies.”