The definition of 'value' is expanding—and it's a good thing

By Pamela Divack, consultant 

How should we define and measure medical value?

Over the last several years, my team and I have been tracking this exact question. After reading the preliminary analysis and related commentary from the ICER report, I'm excited to see an expansion in the way health care leaders—and society overall—defines the "value" of medications. Assessment now goes beyond the traditional static approach of looking merely at safety, efficacy, and upfront costs.  

Specifically, ICER's comments about how Covid-19 treatments can benefit society illuminate how components of medical "value" are not always quantifiable in an economic or clinical analysis. While such debates about "value" have existed for years, society saw this concept unfold firsthand with Covid-19 vaccines and the critical role they played in reopening workplaces, schools, and borders. ICER's report highlights that this is also true for Covid-19 treatments. Not only can Covid-19 treatments generate clinical value by reducing the risk of hospitalizations and deaths, but they can also create societal value through 'psychological reassurance' and an expanded accessibility of care, which has potential to improve health care disparities. However, to actually capture such societal benefits of Covid-19 treatments, health care leaders need to take active steps to make Covid-19 treatments available to patients and overcome critical barriers to access, equity, and communication.

Assessing value beyond Covid-19

This sentiment is applicable beyond Covid-19 related vaccines and treatments. Advisory Board's Cross-Industry Research on medical value has illuminated just how complex the conversation around "medical value" is—especially as one starts to explore underlying tensions in how value is defined, measured, and assessed at both the population and individual patient level. For example, assessing the "value" of a drug or medical product can also involve looking at the patient experience with a course of treatment, or how a product impacts total cost of care. ICER has already taken steps to incorporate such perspectives and consideration in its reports, which is evident in this latest analysis.

What this means moving forward

In the past, value assessments have been relatively static and based on a limited amount of data from randomized control trials (RCT) and fixed prices. Stakeholders, including ICER, have already started to incorporate more real-world data and patient perspectives into "value" analysis. The "value" of a treatment can evolve over time, depending on whether new evidence or information emerges that can impact when, how, and for whom a treatment is used. Moving forward, it's possible that stakeholders take a more dynamic approach to value assessment, updating assessments, prices, and clinical guidelines in real-time based on emerging real-world data and evidence.

Moving forward, there are multiple questions I’ll be closely monitoring:

• How will the final report change with new evidence and information about the treatments (and the pandemic overall)?
• In what other ways has Covid-19 catalyzed conversations about broadening the definition of medical "value" overall?
• Practically, what will it mean for ICER and other health care stakeholders to acknowledge the fact that value changes over time? How will the cadence of value assessments evolve, and what will trigger further assessments?
• How will ICER factor in potential treatment access and coverage restrictions into its analysis?
• If the results of the final report are vastly different than those from the preliminary report, how will life sciences manufacturers respond?