Do Research Groups Align on an Intervention ’s Value? Concordance of Cost-Effectiveness Findings Between the Institute for Clinical and Economic Review and Other Health System Stakeholders

AbstractThe Institute for Clinical and Economic Review (ICER) employs fixed cost-effectiveness (CE) thresholds that guide their appraisal of an intervention ’s long-term economic value. Given ICER’s rising influence in the healthcare field, we undertook an assessment of the concordance of ICER’s CE findings to the published CE findings from other research groups (i.e., “non-ICER” researchers including life science manufacturers, academics, and government institutions). Disease areas and pharmaceutical interventions for comparison were determined based on ICER evaluations conducted from 1 January 2015 to 31 December 2017. A targeted literature search was conducted for non-ICER CE publications using PubMed. Studies had to be conducted from the US setting, include the same disease characteristics (e.g., disease severity; treatment history), incorporate the same pharmaceutical interventions and comparison groups, and present incremental costs per quality-adjusted life-year (QALY) gained from the healthcare sector or payer perspective. Discordance was measured as the proportion of unique interventions that would have had more favorable valuations (i.e., low, intermediate, high value-for-money) if the CE findings from other research groups had been used for decision making instead of ICER’s findings. More favorable valuations wer e defined as transitioning from low value (as determined by ICER) to intermediate or high value (as determined by other researchers) and from ...
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research