Getting Value Right by Considering the Full Range of Benefits for Patients and Caregivers

A study in Health Affairs considers how health care decision-makers can incorporate the benefits associated with a medical treatment when assessing its societal value.

How can health care decision-makers assess the true societal value of prescription medicines and medical services? According to researchers at the National Pharmaceutical Council (NPC), the key is to use a comprehensive approach to measuring value, which takes into account a wide range of potential implications and benefits associated with a medical treatment. This includes incorporating less tangible, patient-centered outcomes often referred to as “indirect benefits,” such as improvements in quality of life, productivity and caregiver burden. However, despite growing pressure from patient organizations, health care economists and other health care stakeholders, indirect benefits are not generally considered by current value assessment frameworks. 

In a blog published in Health Affairs, NPC researchers describe why it’s critical to consider indirect benefits when determining a treatment’s value, and identify opportunities for capturing and improving integration of indirect benefits in health care decision-making.  

The authors highlight three key reasons why indirect benefits should be considered in value assessment. First, failure to account for improvements in indirect benefits like productivity or quality of life may lead to the undervaluation of a treatment that a patient feels is high value. Second, underestimation of treatment value may lead to impaired access to needed treatments for patients and undesirable market incentives for continued innovation. Third, incorporating indirect benefits is consistent with best practice guidelines for value assessment as well as recommendations from the Second Panel on Cost-effectiveness in Health & Medicine, a group of experts responsible for developing standards for reporting cost-effectiveness studies.  

The authors identify three opportunities for broadening the inclusion of indirect benefits in value assessment: 

  1. Guideline bodies need to establish clear standards for measuring the value of indirect benefits by gathering data through clinical trials.
  2. Industry needs to generate data on product-specific indirect benefits using clinical trials and peer-reviewed literature.
  3. Payers and purchasers need to make payment decisions that reflect what matters to patients and their families by using the gathered data to inform their decision-making process.

Improvements in indirect, less tangible outcomes can have a substantial impact on individual patients as well their caregivers and employers. This can generate significant value for patients and their broader social and economic environment. Capturing these indirect benefits does not necessarily mean that health care decision-makers will have to cover more treatments, but it might change how health dollars are allocated once we have a more complete picture of value.