Washington, D.C. — June 14, 2018 — Measuring value in healthcare, which traditionally takes the perspective of a single payer managing population health and costs, needs to evolve to include diverse perspectives and provide relevant and actionable information on value to healthcare decision makers, according to a new article published today in the Journal of Clinical Pathways.
“To successfully deliver value-based care, all healthcare decision makers need actionable data on treatment value at their fingertips – data that are relevant to their own context and reflect their own perspective on what costs and benefits matter,” said Mark Linthicum, Director of Scientific Communications at the Innovation and Value Initiative (IVI), the article’s lead author. “Facilitating the development of next-generation methods to identify these data and the insights they deliver is core to IVI’s mission.”
While the field of cost-effectiveness analysis is increasingly taking the important step of incorporating a broader societal perspective with the common payer assessment, methods that integrate views and value determinants from diverse stakeholders – particularly from patients – are needed to provide actionable information on value, the authors wrote. The authors are members of IVI’s leadership team.
“It’s time for Value Assessment 2.0,” said Jennifer Bright, IVI’s Acting Executive Director, and one of the article’s authors. “IVI is like a test kitchen. We are collaborating with all stakeholders to refine a better recipe for assessing value in an open-source environment.”
IVI launched the Open-Source Value Project (OSVP) in 2017. OSVP, the authors write, is used to develop disease-specific decision models designed to provide scientifically valid and flexible approaches to quantify value. These tools allow users – particularly health plans, employers, and health systems — to evaluate different treatment sequences based on a user-customizable recipe for calculating value. Importantly, users are able to include determinants of value prioritized by patients living with the disease, a unique component of such assessment tools.
“OSVP allows users to tailor an assessment based on what they’ve determined drives value in their patient population,” said Jason Shafrin, Ph.D., IVI’s Director of Research. “Decision makers can then use these assessment factors – such as economic productivity or avoided hospital stays — in a value calculation to reach conclusions most relevant to them. We strongly believe that by placing all OSVP models – including source code – in the public domain, the iterative value-assessment process remains fully transparent and facilitates collaboration across the healthcare ecosystem.”
The first OSVP modeling platform focuses on treatments for moderate to severe rheumatoid arthritis, which requires individualized treatment planning and thus rheumatologists’ flexibility to find the right therapy regimen for their patients. The modeling platform allows users to examine the value of sequencing of therapies through an individual patient simulation.
“Imagine an insurer trying to balance patients’ and rheumatologists’ need for flexibility in treatment decisions against population costs and benefits, for example. The OSVP-RA model provides the means to assess therapy sequencing data more completely, creating insights into the real-world value a therapy sequence is or isn’t delivering,” Linthicum said. “This is particularly important when treatments that perform similarly on clinical measures differ in other ways that are important to patients – for example, in frequency or mode of administration, or the years of safety data on record. In these cases, the insurer has an opportunity to tailor coverage to match what matters to their enrolled patients.”
The authors write that the development of open-source tools is in its infancy, but with ongoing input and collaboration from all stakeholders and real-life applications in settings such as employer benefit development and clinical pathway design, these tools will evolve and improve.
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About the Innovation and Value Initiative
The Innovation and Value Initiative (IVI) is a collaboration among thought leaders in academia, patient advocacy organizations, payers, life sciences companies, providers, delivery systems, and other organizations. It was created to raise the level of discussion regarding value in health care and find common ground in the approach to measuring and rewarding value. IVI’s Strategic Advisory Panel includes experienced leaders from across the health care industry. Their role is to provide advice and ensure the credibility and rigor in the research and policy products and to ensure all parties have a voice in IVI activities.