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Advancing Value Assessment in the United States: A Multistakeholder Perspective

Published on Feb 1, 2017in Value in Health5.037
· DOI :10.1016/J.JVAL.2016.11.030
Corinna Sorenson14
Estimated H-index: 14
(Duke University),
Gabriela Lavezzari2
Estimated H-index: 2
(Duke University)
+ 5 AuthorsMark McClellan46
Estimated H-index: 46
(Duke University)
Sources
Abstract
Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introduced recently to help providers, patients, and payers better understand the potential value of drugs and other interventions and make informed decisions about their use. Given their early stage of development, it is imperative to evaluate these efforts on an ongoing basis to identify how best to support and improve them moving forward. This article provides a multistakeholder perspective on the key limitations and opportunities posed by the current value assessment frameworks and areas of and actions for improvement. In particular, we outline 10 fundamental guiding principles and associated strategies that should be considered in subsequent iterations of the existing frameworks or by emerging initiatives in the future. Although value assessment frameworks may not be able to meet all the needs and preferences of stakeholders, we contend that there are common elements and potential next steps that can be supported to advance value assessment in the United States.
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  • References (14)
  • Citations (13)
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References14
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#1Lowell E. Schnipper (Harvard University)H-Index: 43
#2Alex BastianH-Index: 1
Confronted with the different clinical impacts of different treatments, the rising cost of cancer care, and the financial burden of high drug prices, several influential professional organizations have developed models with which to assess the clinical benefit and value of cancer treatment regimens. The goal is a system of valuing patient therapies that is aligned with the beneficial impact to the patient and society and that moves away from a fixed cost regardless of clinical circumstances.
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#1Ethan Basch (UNC: University of North Carolina at Chapel Hill)H-Index: 60
Cancer drugs are toxic and expensive. Their benefits are often difficult to measure, vary substantially between patients, and too often are quite modest in improving outcomes. Multiple approaches have been developed recently to quantify and combine these treatment characteristics (harms, costs, and benefits) into composite “value” metrics that enable crosstreatment comparisons, formulary prioritization, and assessments of whether pricing is reasonable. In their Viewpoint in this issue of JAMA, C...
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#1Lowell E. Schnipper (Harvard University)H-Index: 43
#2Nancy E. Davidson (University of Pittsburgh)H-Index: 86
Last. Richard L. Schilsky (American Society of Clinical Oncology)H-Index: 68
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Health care costs in the United States present a major challenge to the national economic well being. The Centers for Medicare and Medicaid Services (CMS) has projected that US health care spending will reach $4.3 trillion and account for 19.3% of the national gross domestic product by 2019.1 This growth in spending—both in absolute terms and as a proportion of our gross domestic product—has not been accompanied by commensurate improvements in health outcomes, despite expenditures far exceeding ...
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