The value of health care – a matter of discussion in Germany

Table 1 Calculation of the "intangible value"

Dimensions influencing the "intangible value"	Comparison between effects of two treatment options	Results based on scientific result or consensus
Absolute Risk Reduction [ARR]	ARR>40%:10 pts; 39-25%: 9.9-9.0 pts; 24-15%: 8.9-8.0 pts, 14-10%: 7.9-7.0 pts; 9-5%: 6.9-6.0 pts; ARR<5%: 5 pts	Absolute risk reduction (ARR) = 14% 7.6 points
Validity [V]	Validity (multiplier for not impaired validity = 1.00, for seriously impaired validity = 0.10)	Subjectively determined validity factor: 0.90
Type of expected effectiveness [TEE]	Type of expected effectiveness (TEE) (multiplier for prevention of: death = 10.0; life-threatening event = 9.9-9.0; considerable disability = 8.9-7.0; dis-ability = 6.9-4.0; disturbance in well-being = 3.9-1.0	Subjectively determined type of exp. effectiveness (TEE) = 9.2
	Intangible value (product of ARR score) × (validity factor) × (TEE)	Intangible value = 7.6 points × 0.90 × 9.2 = 62.9 points

The difference in effects (absolute risk reduction) is expressed in score points. These points are multiplied by a validity factor and factor describing the type of expected effectiveness. The given example assumes an ARR = 14%, high validity (0.90) und important type of expected effectiveness (9.2). The calculated intangible value is 62.9 points.

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