Measuring and Valuing Outcomes

Mott, D., Kumar, G., Sampson, C. and Garau, M.

July 2021

Cost-effectiveness analysis (CEA) is the economic evaluation method that is typically preferred by health technology assessment agencies. Quality-adjusted life years (QALYs) – a composite measure of quality and quantity of life – are often used as the measure of benefit in a CEA. The quality of life component requires health state utilities, which are anchored at one (indicating full health) and zero (indicating being dead).

Our new paper explores the evidence currently being used to allocate budgets between public sector activities in the UK and its limitations. We argue that there is much that can and should be done to improve the evidence base to inform the allocation of public sector budgets across portfolios. We propose a pragmatic approach to measure and value disparate public sector outputs in a commensurate manner.

In a new OHE Research Paper, Chris Sampson, David Parkin, and Nancy Devlin consider whether ‘dead’ must be used as an anchor in health state valuation. The authors are looking for feedback from readers to inform future research.

"Methods for Analysing and Reporting EQ-5D Data" is the first published guide on how to analyse data produced by the EQ-5D. The official launch of this new, open-access book will take place as an online event on Tuesday 15th December, 13.00-14.00 GMT.

This blog post summarises some of the more notable changes put forward in NICE’s methods consultation (November – December 2020), and comments on their potential consequences.

Sampson, C., Parkin, D. and Devlin, N.

Research Paper
November 2020

By convention, values for generic ‘preference-based’ measures, such as the EQ-5D, are anchored at 1 = full health and 0 = dead. This paper challenges the assumption that anchoring health state values at ‘dead = 0’ is a necessary condition for values to be used in quality-adjusted life year (QALY) estimation. The authors consider five propositions, using narrative review of the literature and conceptual explication of the problem:

The Virtual ISPOR Europe 2020 will be commencing next week. A number of OHE researchers will be in attendance to present their research.

With the theme Improving Health: Establishing Incentives and Sharing Value, Virtual ISPOR Europe 2020 will question the fundamental conventions around value, risk, rewards, and the role of public and private sectors.

As the world is figuring out how to deal with COVID-19, it is worth taking stock of the broader value that existing vaccines bring to societies suffering from this pandemic. We illustrate this broader value by considering how existing vaccines can help protect people from other respiratory conditions or from COVID-19 co-infections and relieve overburdened healthcare systems.

Berdud, Drummond and Towse (2020) propose a method for establishing a reasonable price for an orphan drug. Assuming prices for drugs are set according to incremental value, they propose adjustments to a payer’s ‘normal’ cost-effectiveness threshold (CET) for non-orphan drugs to ensure orphan drug developers achieve no more than the industry-wide rate of return. Adjustments are calculated for differences in R&D costs and population sizes.

This presentation to the Australian Society for Antimicrobials (ASA) meeting in Melbourne, on 27th February 2020 draws on OHE research, funded by the Wellcome Trust, on adapting HTA methods and contracting for new antibiotics. It analyses UK (NICE and NHSE) plans to introduce a subscription model (delinking use of new antibiotics from payments for making the products available) and suggests that Australia could also pilot such an approach.

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