Using Evidence Appropriately to Inform Value Assessments

The National Pharmaceutical Council recently 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.

Over the next couple weeks, 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 the use of evidence in value assessments.

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When we solve a mystery, develop research criteria or make health care decisions, we rely on evidence to make those determinations. Having a breadth of high-quality, credible evidence for a value assessment is especially important because it will impact the assessment results, ultimately impacting treatment and coverage decisions.

It is critical to use the best available evidence for a value assessment. The evidence should be reviewed to ensure that it is of high quality and certainty and carefully evaluated to determine how to handle conflicting evidence. These review processes should be done in a systematic, transparent and robust manner to maximize credibility and trust in the assessment process.

Sometimes other evidence is available that hasn’t been published in a peer-reviewed journal or other public documents, yet is vitally important to decision-makers. This could include clinical trial data or real-world evidence developed by biopharmaceutical manufacturers or other researchers. Stakeholders should be provided with an opportunity to submit this evidence to framework developers and value assessors.

In some cases, there may be a lack of high-quality evidence altogether. To make up for this gap in information, “subjective evidence”—basically expert opinion—could be utilized. Yet expert opinion could be biased by the expert’s experiences or beliefs, making it less reliable. For those reasons, the use of subjective evidence should be minimized, clearly labeled, and the user should be made aware of the potential limitations.

Pulling all of this sometimes disparate evidence together can be challenging, which is why assessors should conduct a formal analysis of the evidence, using accepted methodologies. Doing so could help to ensure a more meaningful and credible assessment.

Following these practices in the use of high-quality, credible evidence can help stakeholders more confident in the information provided to them through a value assessment.