Should Value Frameworks Take A ‘ Societal Perspective ’ ?

Editor’s note: One of the authors of this post, Peter Neumann, will be discussing issues related to the post at a Health Affairs September 13 event, “Understanding The Value of Innovations In Medicine.” In 1996, the U.S. Panel on Cost-Effectiveness in Health and Medicine recommended that analysts conducting cost-effectiveness analyses (CEAs) should perform a reference case analysis, following a set of standard methodological practices to improve comparability and quality. They further recommended that such analyses assume a societal perspective, reflecting the perspective of a decision maker allocating resources broadly across the entire population (such as consequences of interventions that fall outside the health sector). Since publication of the original Panel’s report, researchers have published thousands of CEAs. However, as highlighted in the recently published report of the Second Panel on Cost-Effectiveness in Health and Medicine (Note 1), many if not most CEAs have failed to use a societal perspective. Only 341 (29 percent) of 1,163 cost per quality-adjusted life year (QALY) analyses published through 2005 adopted a societal perspective, for example. Most published CEAs have omitted important elements—e.g., excluding costs related to patient and caregiver time or costs outside the health sector. Moreover, since the original Panel’s book, decision making bodies (e.g., the National Institute of Care Excellence) that have used CEAs to inform reimb...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Innovation Quality 2nd Panel on Cost-Effectiveness in Health and Medicine Source Type: blogs