Defining value of a treatment can be complicated, but at the center of it is the need to include both long-term and short-term effects, said Steven Pearson, MD, MSc, FRCP, founder and president of the Institute for Clinical and Economic Review.
Defining value of a treatment can be complicated, but at the center of it is the need to include both long-term and short-term effects, said Steven Pearson, MD, MSc, FRCP, founder and president of the Institute for Clinical and Economic Review (ICER).
There has been a lot of discussion about what value means and the definition can change depending on the stakeholder. What is ICER’s definition of value?
Value is a combination and that’s the hard part: there is no one thing, no matter how you define value there are different perspectives and that shouldn’t be lost. But to a certain extent our view of value is rooted most strongly in the long-term added benefits that a drug brings to patients, and the long-term added costs, if any. So that’s the anchor.
Once you gather that as a key part of value, you also often want to look at other considerations. For instance, is it a very, very severe condition for which we’ve never had any kind of adequate treatment? That influences everyone’s perspective on value, not just patients but doctors, insurers, and everybody else. So that’s why value is always going to be multifaceted.
But you look at that long-term mixture of the clinical outcomes and the costs, and then we look at the potential budget impact for affordability because if something if a great long-term value we still have to at least think about the value in the short-term to the health system, and how we manage that. It might mean that we have to lower the price further, even if it’s a good long-term value, or it might mean that we need to go slow and not treat so many patients initially, or find extra resources from savings and other parts of the healthcare system, or from somewhere else.
All of that’s possible, but you can’t have a real comprehensive view of value, in our eyes, unless you integrate and merge considerations long term and short term.