Table 1 Classification of existing value assessment frameworks
Contextual information | Interpretive classification system | |||||
|---|---|---|---|---|---|---|
Approach Name | Who uses it? | Which purpose? | One consideration or multiple considerations? | Disease-specific or generic criteria? | Process-related or outcomes criteria? | Who inputs and what evidence? |
American Society of Clinical Oncology (ASCO) framework [9, 10] | The American Society of Clinical Oncology | To provide a formal approach to define value of cancer treatments and a tool to facilitate one-on-one discussions with patients regarding the relative value of various treatment options. | Multiple | Specific | Outcomes | Trials; expert panel; patient feedback |
- Pharmaceutical industry clinical trial professionals - Health Maintenance Organizations (HMOs) - Veterans Health Administration | - To determine the intervention with the best value for that specific disease. - To discuss the challenges and opportunities to develop comparative research and using its results to improve patient care. | Multiple | Specific | Outcomes | Data-driven | |
Cost/Value Methodology [13] | - American College of Cardiology - American Heart Association | - To enhance overall value in the delivery of cardiovascular care. - To involve healthcare professionals in the difficult decisions that must be made to increase value in the U.S. healthcare system. | One | Generic | Outcomes | Clinical trials |
Cost-effectiveness / Cost-utility Analysis [14,15,16,17,18,19,20,21,22,23,24,25] | - Health care centers - Academic researchers - HTA agencies - Governmental departments responsible for health care funding - Pharmaceutical industries | - To determine the more effective and economically attractive strategy among a set of options - To assess whether specific technology is cost-effective in comparison to mainstream intervention | One | Generic | Outcomes | Clinical trials/ decision analysis |
Discrete Choice Experiment (DCE) [26] | - International collaboration of academic researchers | To elicit social values and public preference for the allocation of resources across a wide range of health technologies | Multiple | Generic | Outcomes | Survey of public |
Drug Abacus framework [27] | - Drug Abacus | To assess the value of cancer drugs, allowing users to build preferences for different drug attributes into the tool’s value. | Multiple | Generic | Outcomes | Expert opinion |
Economic priority and conformity [28] | - Academic researchers in Australia | To establish the value of Indigenous eye health programs (IEHPs) using not only the health and heath care needs approach, but also the economic priority and performance standards approach using all relevant benchmarks. | Multiple | Specific | Outcomes | Data-driven |
High value care process [29] | Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California | To optimize the use of ancillary services in ICU. | Multiple | Specific | Process and outcomes | Data-driven |
Institute for Clinical and Economic Review (ICER) framework [27, 30] | Institute for Clinical and Economic Review framework | To assess the value of cancer drugs. | Multiple | Generic | Outcomes | Clinical trials and expert opinion |
- Health care organizations - Private companies focused on evidence-based assessments. - Academic researchers - International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force | - To provide transparency and consistency for decision making processes. - To combine multiple criteria in a single judgment of a health care technology by multiple stakeholders. | Multiple | Generic | Outcomes | Expert panel | |
National Comprehensive Cancer Network (NCCN) framework [30] | National Comprehensive Cancer Network | To assess the value of drug treatments with the consideration of multiple criteria. | Multiple | Specific | Outcomes | Expert opinion |
- Academic researchers | - To assess whether the value of changes in health care for patients with type 2 diabetes, defined as the prevention of future mortality and morbidity, exceeds the increase in costs of that management. - To estimate the clinical and economic return of trial compared to a scenario where the trial had not been conducted. | One | Generic | Outcomes | Data-driven | |
- Academic researchers - Health care organizations - Governmental health care authorities | - To serve as a broad mean of prioritizing resource allocation. - To improve the management of public health interventions at the national level (in Wales), bringing a culture of evidence-based decision making into routine policy. - To bring expenditure in line with available funds. - To determine a list of options for disinvestment generating cost savings for other investment intentions. | Multiple | Generic | Outcomes | Expert panel | |
Six Sigma methodology [38] | Hospital | - To explore the waste location in a process and to identify the risk in advance and prevent the occurrence of possible errors in the process. - To reach the goal of “zero” specimen rejections within the hospital. | Multiple | Specific | Process | Data-driven |
Surgical auditing [39] | Hospital | To provide/improve quality information leading to the identification of existing problems in the care process. | Multiple | Specific | Outcomes | Data-driven |
System cost-effectiveness [40] | - Academic researchers -Health care organizations | To elicit the health value of suboptimal treatment approaches. | Multiple | Specific | Outcomes | Expert panel |
Systematic evidence-based quality measurement [41] | - Centers for Medicare and Medicaid Services (CMS) - Agency for Healthcare Research and Quality (AHRQ) | To reexamine selected health care quality measures from a child core set (CCS) voluntarily reported on by a number of state Medicaid and Children’s Health Insurance Program (CHIP) programs over the 3 federal fiscal years in the US. | Multiple | Specific | Process | Data-driven |
Value framework for specialty drugs [42] | Hospital Pharmacy & Therapeutics Committee | To assess the value of specialty drugs in order to decide which ones to be funded within a hospital setting. | Multiple | Generic | Outcomes | Expert opinion |
Value-based decision [43] | Hospital | To determine the relevance, quality, and cost of perioperative clinical initiatives. | One | Specific | Process | Data from monitoring |
Value-based proposition [44] | Academic researchers | To test funding propositions based on Porter’s model of value | Multiple | Specific | Outcomes | Expert opinion |
Value-driven outcomes [45] | Academic researchers in the US | To understand and improve healthcare value that is focused on delivering practical utility (pragmatic), implemented using components that can be independently enhanced (modular), and capable of being improved over time (extensible). | Multiple | Specific | Process | Data-driven |
Value-driven outcomes program [46] | Academic researchers in the US | - To identify overall care costs across the health care system. - To measure cost variability across Medicare severity diagnosis related groups (MS-DRGs) to identify the greatest opportunities for cost reduction and outcome optimization. - To support value improvement initiatives for selected conditions. | Multiple | Generic | Outcomes | PROMs |