Methodology Matters in Value Assessments
Earlier this week, the National Pharmaceutical Council unveiled “Guiding Practices for Patient-Centered Value Assessment,” which offer comprehensive considerations for the development and application of frameworks for assessing the value of health care. 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.
NPC’s guiding practices include 28 specific elements, which are broken out into six key aspects of value assessments: the assessment process, methodology, benefits, costs, evidence, and dissemination and utilization.
During the next few days, we’ll take a closer look at each of these six main areas, along with our thoughts on budget impact analyses. Today, we continue the series with our post on methodology.
-------------------
When it comes to conducting research, synthesizing evidence or assessing value, the methods that are used truly matter. Poor methods lead to poor results, which in turn lead to poor health decision-making. That’s why value assessments should focus on all aspects of the health care system, use established methods and transparent models and assumptions, and identify the range of potential results. These sound practices, outlined in NPC’s guiding practices for patient-centered value assessment, can lead to stronger, more meaningful assessments for users.
More specifically, NPC’s guiding practices outline six key elements for ensuring the use of sound methodology in the development and application of value assessment frameworks:
- Value assessments should focus broadly on all aspects of the health care system, not just on medications. Viewing just one aspect—like medications—while ignoring the rest of the health care system—such as procedures, diagnostic tests, hospitalizations, doctor visits—will result in an incomplete assessment.
- Assessments should follow established and accepted methodological standards (such as International Society for Pharmacoeconomics and Outcomes Research Good Practices, Cochrane Collaboration) that have been shaped by years of debate and research in order to produce a meaningful and credible assessment of value.1 2
- The methods, models and assumptions included in the assessment should be transparent to all interested stakeholders and should be reproducible.
- The base case—or underlying foundation and assumptions from which the results are derived—must use realistic and accurate assumptions. Otherwise the final results will not be accurate or useful to users.
- Identifying and understanding the range of potential results—known as a sensitivity analysis—with input from stakeholders is important. Clear guidance will be needed to help stakeholders understand which assumptions are driving the range of results and why.
- Users may have preferences for different outcomes and factors (eg, clinical benefits vs. side effects), so they should be able to “weight” or adjust the assumptions and parameters to account for those preferences.
By utilizing these elements, value assessments can better lead to meaningful results and improved health care decision-making for users.
- ISPOR Good Practices for Outcomes Research Index. http://www.ispor.org/workpaper/practices_index.asp accessed 2/23/2016.
- Cochrane Methods. http://methods.cochrane.org/ accessed 2/23/2016.