Budget Impact Analysis: An Acceptable Part of Value Assessments or a Discordant Concept?

Value assessments are an evolving area, yet growing in use as health care stakeholders look for ways to evaluate the value of care that is being provided to patients.

But there’s an ideological clash brewing as to whether budget impact analyses (BIAs) should be included in value assessments. According to many health economists, a BIA is only a measure of resource use, not a measure of value. It can inform end users about what they are paying, but not about what they are paying for—value. Therefore, BIAs have the potential to affect patients considerably as payers use them to make coverage and reimbursement decisions. The way they are used collectively could have a considerable impact on society, such as discouraging innovation in highly prevalent diseases.
Not everyone views BIAs in the same way, and even one value assessment framework includes a BIA as part of its process.

To debate this issue, NPC is sponsoring an educational symposium, “Budget Impact Analysis: An Acceptable Part of Value Assessments or a Discordant Concept?” (Room: Intl Ballroom East) on Sunday, May 22, at 5:15 pm ET at the International Society for Pharmacoeconomics and Outcomes Research 21st Annual Meeting.

Dan Leonard, MA, president of NPC, will moderate the symposium, featuring a panel of experts who have developed or reviewed value assessment frameworks:

• Darius N. Lakdawalla, PhD, Quintiles Chair, pharmaceutical development and regulatory innovation; professor, Sol Price School of Public Policy, School of Pharmacy, University of Southern California (@USCPrice)
• Peter J. Neumann, ScD, professor and director, Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center (@TuftsMedicalCtr)
• Steven Pearson, MD, MSc, FRCP, president, Institute for Clinical and Economic Review (@icer_review)
• Matt Salo, executive director, National Association of Medicaid Directors

NPC also has conducted a review of existing value assessment frameworks, comparing and contrasting key characteristics such as their intended purposes, development processes, methods, and the elements of value (benefits and costs). By comparing and contrasting these frameworks, we can lay the groundwork for a dialogue about what elements should be included in a value framework, how those elements should be measured, and how a value assessment should be conducted and utilized. As a starting point, NPC has developed Guiding Practices for Patient-Centered Value Assessment Frameworks, which outline six key aspects of value assessments: the assessment process, methodology, value factors, cost factors, evidence, and dissemination and utilization. In our view, establishing good practices to guide value assessments can help ensure they are effective tools to support value in patient care and outcomes, rather than well-intentioned but flawed tools that impede it.

We hope you’ll join us for the “clash” at ISPOR on Sunday night—and be sure to stop by our other panels, poster sessions and exhibition booth while you’re there.