Unbiased Analysis of Today's Healthcare Issues
When evaluating a new diagnostic, HTA agencies must assess two separate issues: analytical and clinical validity. Analytical validity basically indicates whether the test works; is it able to accurately predicts the presence or absence of a particular biomarker of interest. Clinical validity is whether the test matters in clinical practice. It could be the case…
A nice (pun intended) paper by Thokala et al. (2020) compares the Institute for Clinical and Economic Review (ICER) with the National Institute for Health and Care Excellence (NICE) along 4 dimensions: structure, methods, process, and use in decision-making. While ICER and NICE methods are fairly similar, ICER is a non-governmental body without any explicit…
Is it clinical benefit? Cost? Value? The availability of treatment alternatives? To answer this question, a paper by Wranik et al. (2019) conducted a discrete choice experiment DCE to determine HTA stakeholders stated preferences. The sample consisted of HTA stakeholders from 5 countries: Australia, Canada, Germany, Poland, and the United Kingdom. The stakeholders included not…
Many health technology assessment (HTA) agencies give additional consideration to treatments if there is unmet need. But what really defines unmet need? According to an article by Vreman et al. (2019), there are three key elements. First, there should be no or limited treatment alternatives. If there are lots of good treatment options available, then…
In general, health economists would like to have health insurers cover treatments that are welfare improving in the Pareto sense. This means, if a treatment provides more expected benefits than costs and no one is worse off (in expectation), then this treatment should certainly be covered. It could be the case, however, that people care…
Health technology assessment (HTA) is growing in popularity. Already widely entrenched in Europe, in the U.S. value frameworks are being used to measure the cost effectiveness of different therapies. Some of these frameworks, however, take a narrow view of societal benefits and value to include components of value to patients or society such as caregiver…
This is the question asked by a study conducted by Brogen et al. (2017). To see how payers use patient reported outcomes (PRO) in oncology, the authors conducted a literatures search, and searched the websites of the following health technology assessment bodies: Pharmaceutical Benefits Advisory Committee (PBAC) in Australia, Canadian Agency for Drugs and Technologies…
Health technology assessments (HTAs) aim to measure the cost effectiveness of a given treatment or set of treatments for a specific patient populations. Often, these assessments are conducted from the point of view of the payer–either a national health system or the individual insurer perspective. This payer focused perspective can often focus largely on treatment costs rather…
Health technology assessments aim to evaluate the costs and benefits of various healthcare treatments and technology. Many organizations that conduct HTAs say they wish to incorporate the patient perspective. In practice, this does not happen often. When it does, there are a number of methodological complexities. How do you incorporate the patient perspective into HTA? A…
The National Institute for Health and Care Excellence (NICE) claims that although cost-effectiveness is highly valued in its health technology appraisal process, it sates that there are other factors considered relevant. However, no explicit weight is assigned to these other factors. Do they matter? A paper by Dakin et al. (2015) tries to answer this question by looking…