Charting a Course to Value Assessment 2.0

IVI envisions a new approach to value assessment that is patient-centered, transparent, and adaptable to local contexts. We pursue that vision by:

Every individual and organization who interacts with the U.S. healthcare system has a stake in how we assess the value of healthcare interventions. Traditional approaches that provide little transparency, limited perspective, and static evidence fail to meet the diverse and evolving needs for information among these stakeholders. IVI is redefining how value is assessed by pioneering an open-source and consensus-driven process for building flexible value assessment model platforms.
Every day, countless decision-makers weigh the relative value of treatment options for patients. Patients and providers make choices about treatment strategies. Insurers make formulary and coverage decisions. Hospital systems decide how to allocate their resources to ensure access for critically ill patients. Employers struggle to contain growing health care budgets, and the list goes on. IVI provides these diverse stakeholder groups with innovative tools to determine the value of alternative treatments, based on patients’ specific clinical circumstances, preferences, and insurance arrangements.
To accurately and comprehensively measure value, new methods are needed that capture hard-to-measure costs and benefits and incorporate the perspectives of multiple stakeholders. IVI conducts research that develops state-of-the-art methods for measuring the value of new medical technologies. IVI also supports initiatives that educate and advise practitioners, healthcare system stakeholders, and policymakers about these methods to ensure they become a part of standard practice.
Through comprehensive outreach and engagement, IVI identifies patients and patient organization partners to define early research on patient preferences during treatment of a targeted disease state for which IVI desires to conduct model development. Patient partners collaborate with IVI in designing research approaches, identifying participants and reviewing preliminary findings to ensure representativeness and accuracy. Patient partners also collaborate on publication and scientific communication, when desired and feasible. Such collaboration at the front end of IVI work ensures patient-centered principles are upheld throughout our process and contribute to authentic, informed research and development on OSVP models and methods.
Outreach to provider organizations, health plans, payers, employers and other stakeholders that represent both users and decision makers allow IVI to test its models in real-decision environments, with potential access to real data sources for robust tests of our models. Such collaboration will lead to further scientific communication of the impact and need for open-source value assessment methods and models, and advance a balanced dialogue with all users to improve how value is defined and measured.

Nearly unprecedented consensus has emerged over the need to align reimbursement and utilization with value… [but] we cannot reward value until we properly measure it.

Darius Lakdawalla and Peter Neumann, Writing on the Health Affairs Blog

Research Driving Progress

Research is the first ingredient in developing improved approaches to estimating value in healthcare. IVI’s research projects support the development of Open-Source Value Project models providing insights into the patient experience and filling gaps in existing methods – and as IVI receives feedback on its work, our research plans continue to evolve.

Patient Perspectives on Value in the Treatment of Non-Small Cell Lung Cancer

Understanding what determines value from the patient perspective is vital to healthcare decision-making and the delivery of high-quality clinical care. IVI conducted qualitative research to better understand how patients with non-small cell lung cancer (NSCLC) prioritize various treatment attributes, such as health states, side effects, and mode of administration. The findings from this research, outlined in the IVI report, are informing related research and model development at IVI by gaining a better understanding of the patient’s experience with lung cancer treatment.

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Expanding Cost-Effectiveness Analysis (CEA) to All of Health Care: Comparisons Between CEAs on Pharmaceuticals and Medical/Surgical Procedures

Cost-effectiveness analysis has been applied extensively for pharmaceuticals, but less so for medical and surgical goods and services, we evaluate similarities and differences between characteristics of pharmaceutical CEA studies and CEA studies of medical or surgical procedures, and examine potential policy solutions to achieve a more balanced mix of CEAs across interventions and ultimately help us better diagnose and treat patients.

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Patient Insights on Value in Rheumatoid Arthritis

IVI worked with focus groups to explore patient’s perspectives on care for rheumatoid arthritis (RA) and learn how RA patients deliberate their treatment options. The specific objectives of the focus groups were to 1) identify attributes of treatment that RA patients prefer or prioritize as most important in their treatment decisions, and 2) elicit recommendations for, and assess the utility of, a web tool to facilitate decision-making about RA treatment. Findings outlined in the IVI report are based on focus groups conducted in January 2017 with RA patients residing in the Atlanta, Georgia metropolitan area.

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Impacts of Heterogeneity in Patient Preferences on Value in Lung Cancer

When doing value assessment, the typical approach is to compare alternative treatment options for the average patient when using a single measure of benefit, such as quality-adjusted life years. However, heterogeneity in patient preferences for other attributes may influence relative value but is not captured in this type of approach. Using the IVI-NSCLC model, this project explores how accounting for diverse preferences by using multi-criteria decision analysis (MCDA) may lead to different conclusions about the relative value of treatments.

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