Value Assessment Frameworks in the United States: A Call for Patient Engagement

• Published in: PharmacoEconomics - open Vol. 3; no. 1; pp. 1 - 3
• Main Authors: Diaby, Vakaramoko, Ali, Askal A., Montero, Alberto J.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2019; Springer Nature B.V
• Subjects: Cancer; Cardiology; Clinical outcomes; Clinical practice guidelines; Cost control; Decision making; Editorial; Funding; GDP; Gross Domestic Product; Health care expenditures; Health care policy; Medicine; Medicine & Public Health; Oncology; Patients; Performance evaluation; Pharmaceuticals; Pharmacoeconomics and Health Outcomes; Pharmacy; Reimbursement; Task forces; United States > US
• ISSN: 2509-4262; 2509-4254
• DOI: 10.1007/s41669-018-0094-z

In the United States (US), decision-making regarding the evaluation of healthcare technologies was originally informed by health technology assessment (HTA) as evidenced by the creation of the Office of Technology Assessment (OTA) in 1972 [1]. Since the 1990s, healthcare expenditures in the US, as a percentage of gross domestic product (GDP) have dramatically risen compared to peer Organisation for Economic Co-operation and Development (OECD) countries, with healthcare outcomes that lag significantly behind other peer countries that spend much less. [...]the US has started transitioning from a volume-based healthcare system to one that focused more on “value” [2]. OTA Office of Technology Assessment (1972) (role: assessing the effectiveness and cost-effectiveness of healthcare services), NCHT National Center for Healthcare Technologies (1975) (role: endorse research on healthcare technologies), AHCPR/AHRQ Agency for Health Care Policy and Research/Agency for Healthcare Research and Quality (1989) (role: development of evidence and clinical practice guideline), MMA Medicare Prescription Drug, Improvement, and Modernization Act (2003) (role: list of required research to demonstrate the outcomes, comparative clinical effectiveness, and appropriateness of healthcare items and services), PCORI Patient-Centered Outcome Research Institute (2010) (role: fund comparative effectiveness research), VAFs value assessment frameworks (2014–present) Professional organizations involved in the development of value assessment frameworks include the American Society of Clinical Oncology (ASCO) [5], the American Heart Association (AHA)/the American College of Cardiology (ACC) [6], the Institute for Clinical and Economic Review (ICER) [7], the Memorial Sloan Kettering Cancer Center (MSKCC) [8], and the National Comprehensive Cancer Network (NCCN) [9]. [...]more evidence-based, reproducible, and transparent frameworks are needed.