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Considering patient perspectives in economic evaluations of health interventions

Current guidelines for evaluating the cost-effectiveness of health interventions commonly recommend the use of a payer and/or a societal perspective. This raises the concern that the resulting reimbursement decision may overlook the full spectrum of impacts and equity considerations. In this paper,...

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Autores principales: Fu, Rui, Ng, Vivian, Liu, Michael, Wells, David, Yurga, Emre, Nauenberg, Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593459/
https://www.ncbi.nlm.nih.gov/pubmed/37876714
http://dx.doi.org/10.3389/fpubh.2023.1212583
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author Fu, Rui
Ng, Vivian
Liu, Michael
Wells, David
Yurga, Emre
Nauenberg, Eric
author_facet Fu, Rui
Ng, Vivian
Liu, Michael
Wells, David
Yurga, Emre
Nauenberg, Eric
author_sort Fu, Rui
collection PubMed
description Current guidelines for evaluating the cost-effectiveness of health interventions commonly recommend the use of a payer and/or a societal perspective. This raises the concern that the resulting reimbursement decision may overlook the full spectrum of impacts and equity considerations. In this paper, we argue that a potential solution is to supplement a societal- or payer-perspective economic evaluation with an additional evaluation accounting for exclusively the patient perspective. We present five categories of health interventions for which a patient-perspective analysis may be informative including those (1) that cross the definitional boundary between drugs and non-drug technologies; (2) affect patient adherence to protocol; (3) represent revolutionary treatments for genetic disorders; (4) with an incremental cost-effectiveness ratio involving slightly less effective, but substantially less costly, than the current standard; and (5) have been previously approved for funding but now being targeted for potential delisting or disinvestment. Real-world examples are discussed in detail. Lived experience individuals were invited to provide vignettes. Discussions are provided regarding how to incorporate patient inputs to improve patient-centered decision-making.
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spelling pubmed-105934592023-10-24 Considering patient perspectives in economic evaluations of health interventions Fu, Rui Ng, Vivian Liu, Michael Wells, David Yurga, Emre Nauenberg, Eric Front Public Health Public Health Current guidelines for evaluating the cost-effectiveness of health interventions commonly recommend the use of a payer and/or a societal perspective. This raises the concern that the resulting reimbursement decision may overlook the full spectrum of impacts and equity considerations. In this paper, we argue that a potential solution is to supplement a societal- or payer-perspective economic evaluation with an additional evaluation accounting for exclusively the patient perspective. We present five categories of health interventions for which a patient-perspective analysis may be informative including those (1) that cross the definitional boundary between drugs and non-drug technologies; (2) affect patient adherence to protocol; (3) represent revolutionary treatments for genetic disorders; (4) with an incremental cost-effectiveness ratio involving slightly less effective, but substantially less costly, than the current standard; and (5) have been previously approved for funding but now being targeted for potential delisting or disinvestment. Real-world examples are discussed in detail. Lived experience individuals were invited to provide vignettes. Discussions are provided regarding how to incorporate patient inputs to improve patient-centered decision-making. Frontiers Media S.A. 2023-10-09 /pmc/articles/PMC10593459/ /pubmed/37876714 http://dx.doi.org/10.3389/fpubh.2023.1212583 Text en Copyright © 2023 Fu, Ng, Liu, Wells, Yurga and Nauenberg. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Fu, Rui
Ng, Vivian
Liu, Michael
Wells, David
Yurga, Emre
Nauenberg, Eric
Considering patient perspectives in economic evaluations of health interventions
title Considering patient perspectives in economic evaluations of health interventions
title_full Considering patient perspectives in economic evaluations of health interventions
title_fullStr Considering patient perspectives in economic evaluations of health interventions
title_full_unstemmed Considering patient perspectives in economic evaluations of health interventions
title_short Considering patient perspectives in economic evaluations of health interventions
title_sort considering patient perspectives in economic evaluations of health interventions
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593459/
https://www.ncbi.nlm.nih.gov/pubmed/37876714
http://dx.doi.org/10.3389/fpubh.2023.1212583
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