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The Value of Medicines: A Crucial but Vague Concept

Author

Listed:
  • Fernando Antoñanzas

    (University of La Rioja)

  • Robert Terkola

    (University of Florida
    University of Groningen)

  • Maarten Postma

    (University of Groningen
    University of Groningen
    University of Groningen)

Abstract

Health Technology Assessment is increasingly used to evaluate the value of healthcare products and to prioritize resources; however, defining exactly what value is and how it should be measured remains a challenge. In this article, we report the results of a literature review, focusing on nine European countries, with the aim of investigating how value is defined from the perspective of different stakeholders, how definitions of value are used, and how value is incorporated into decision making. Only three articles were identified that presented definitions of value, and there was no single shared definition of value in healthcare, which appears to be a highly subjective concept. The majority of the countries investigated combine clinical assessment with economic evaluation to make reimbursement recommendations; the quality-adjusted life-year is the most commonly used measure of value but does not capture broader aspects of value that may be important to patients and healthcare systems. We describe the use of value-based pricing and multi-criteria decision analysis, two approaches to the incorporation of broader aspects of value into decision making. Overall, we have identified considerable variation in how a product’s value is defined by different stakeholders. Although a universal understanding of value in healthcare is important, it is clear that current definitions are insufficient, potentially leading to inconsistent reimbursement decisions. Ultimately, the establishment of clearer policies for defining and measuring value in healthcare is needed, and is likely to lead to improvements in the consistency of decision making.

Suggested Citation

  • Fernando Antoñanzas & Robert Terkola & Maarten Postma, 2016. "The Value of Medicines: A Crucial but Vague Concept," PharmacoEconomics, Springer, vol. 34(12), pages 1227-1239, December.
  • Handle: RePEc:spr:pharme:v:34:y:2016:i:12:d:10.1007_s40273-016-0434-8
    DOI: 10.1007/s40273-016-0434-8
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    References listed on IDEAS

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    1. László Gulácsi & Alexandru Rotar & Maciej Niewada & Olga Löblová & Fanni Rencz & Guenka Petrova & Imre Boncz & Niek Klazinga, 2014. "Health technology assessment in Poland, the Czech Republic, Hungary, Romania and Bulgaria," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 13-25, May.
    2. P. Thokala & A. Duenas, 2012. "Multiple Criteria Decision Analysis for Health Technology Assessment," Post-Print hal-00800398, HAL.
    3. Valérie Paris & Annalisa Belloni, 2013. "Value in Pharmaceutical Pricing," OECD Health Working Papers 63, OECD Publishing.
    4. Brousselle, Astrid & Lessard, Chantale, 2011. "Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path," Social Science & Medicine, Elsevier, vol. 72(6), pages 832-839, March.
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    Cited by:

    1. Mónica D. Oliveira & Inês Mataloto & Panos Kanavos, 2019. "Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 891-918, August.
    2. Angelis, Aris & Kanavos, Panos, 2017. "Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework," Social Science & Medicine, Elsevier, vol. 188(C), pages 137-156.
    3. Robert Terkola & Fernando Antoñanzas & Maarten Postma, 2017. "Economic evaluation of personalized medicine: a call for real-world data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1065-1067, December.

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