When a new health care innovation comes to market, how do patients, health care providers, and health care payers determine its value?
Organizations like the Innovation and Value Initiative (IVI), Institute for Clinical and Economic Review (ICER), and National Comprehensive Cancer Network (NCCN) seek to determine the value of new drugs, medical tests, and other health care innovations by examining clinical, economic, and other relevant evidence to figure out how much better the new intervention is at improving health than the current clinical standard.
Each organization has their own value framework — the approach they use in assessing new products or interventions. SWHR is committed to ensuring value frameworks are designed to comprehensively measure value and used to provide appropriate access to innovative new therapies and interventions for women.
To achieve optimal health outcomes for women as patients, caregivers, and health care decision-makers for themselves and their families, women’s unique needs must be considered throughout the value assessment process. SWHR has conceived a set of principles to help ensure value frameworks and assessments reflect factors relevant to women and the ongoing improvement of their health.
SWHR’s Health Care Value Assessment Principles
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- Value assessments should account for diversity in patients (including sex and gender) for a given disease state by analyzing data that represents relevant patient populations and subgroups.
- Value assessments should acknowledge the full spectrum of treatment options for a given medical condition, not focus exclusively on one type of medical intervention, as patient subpopulations can differ in their response to therapy.
- In addition to measuring clinical outcomes, value assessment frameworks should account for what matters most to patients, caregivers, and society, while recognizing that these values vary and change across patient populations.
- Value assessments should take into consideration the long-term benefits of a therapy because focusing only on short-term outcomes may overlook important clinical benefits that can only be measured over a significant time horizon.
- Value assessments should use a range of high-quality evidence to demonstrate an improvement in outcomes, including real-world evidence and data from caregivers (the majority of whom are women).
- Value assessment organizations should provide ample engagement opportunities for stakeholders (especially those who have direct experience/expertise with a particular illness and its burden) to ensure their input is acknowledged and meaningfully incorporated into assessments.
- Value assessment processes, methodologies, and results should be transparent and understandable for all stakeholders.
- The intended use of value assessment frameworks, and by whom, should be clearly articulated to ensure that they are not used to prevent patients and their physicians from making evidence-based decisions tailored to the needs of individual patients.
For more information on each of these principles, read SWHR’s in-depth policy principles on value assessment here.
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