A yearlong collaboration between a health consultancy and a think tank has resulted in the first draft of a framework that considers the value of healthcare services from the patient’s perspective—the Patient Perspective Value Framework (PPVF).
Avalere Health and FasterCures, a center of The Milken Institute, initiated a collaboration in June 2016 to develop PPVF. The objective was to incorporate the framework, or parts of it, into existing value framework platforms, including the American Society of Clinical Oncology (ASCO)’s Value Framework
, the Institute for Clinical and Economic Research (ICER)’s Value Assessment Framework
, and the National Comprehensive Cancer Network (NCCN)’s Evidence Blocks
The 2 organizations convened multiple stakeholders to steer the development of PPVF, including patient groups (Cancer Support Community, Leukemia & Lymphoma Society, Michael J Fox Foundation, and National Multiple Sclerosis Society); healthcare think tanks (FasterCures, National Health Council, Partnership to Improve Patient Care, and Patient-Centered Outcomes Research Institute); payers (Aetna and CVS Health); pharmaceutical developers and their representatives (Amgen, Astellas Pharma, Biogen, Edwards Lifesciences, Gilead Sciences, GlaxoSmithKline, Johnson & Johnson, Pharmaceutical Research and Manufacturers of America, and Sanofi); and others (American Heart Association and Better Medicare Alliance).
“As the US healthcare system transitions to value-based payment, it is imperative that we get the value definition right and measure what truly matters to the patient,” Josh Seidman, senior vice president in Avalere’s Center for Payment and Delivery Innovation, said
in a statement. He believes that PPVF can assist healthcare organizations integrate what matters to patients in their payment models.
There are 5 components that reside within this framework:
Patient preferences. This domain, which assesses a patient’s personal goals and preferences, weighs 3 other domains of the PPVF: patient-centered outcomes, patient and family costs, and quality and applicability of evidence. It measures the patient’s values, needs, goals/expectations, and financial tradeoffs.
Patient-centered outcomes. This domain assesses the clinical, functional, and quality of life benefits and drawbacks of various healthcare options for the patient.
Quality and applicability of evidence. This domain evaluates the strength and consistency of evidence and its relevance for an individual patient.
Patient and family costs. This domain uses insurance benefit design and patient-reported data to calculate the medical, nonmedical, and future costs of healthcare options for the patient and their family.
Usability and transparency. To ensure usability of the framework for the intended audience and assess the transparency of the framework’s approach, this domain determines how the weighted assessments of the other domains will be communicated through a specific application.
The developers of PPVF envision using this framework for shared decision-making, incorporating it within existing value frameworks, supporting public health programs, and to inform patient-centered drug development.
Future plans include collaborating with other framework developers, and to that effect, representatives from ASCO, ICER, NCCN, and Memorial Sloan Kettering’s DrugAbacus participated in a meeting with PPVF’s steering committee to discuss potential opportunities for collaboration.
The next phase of the initiative is expected to kick off in June 2017.