Approaches to Aggregation and Decision Making-A Health Economics Approach: An ISPOR Special Task Force Report [5].

Autor: Phelps CE; Economics, Public Health Sciences, Political Science, University of Rochester, Gualala, CA, USA. Electronic address: charles.phelps@rochester.edu., Lakdawalla DN; Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA., Basu A; University of Washington, Seattle, WA, USA., Drummond MF; Centre for Health Economics, University of York, York, UK., Towse A; Office of Health Economics, London, UK., Danzon PM; The Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2018 Feb; Vol. 21 (2), pp. 146-154.
DOI: 10.1016/j.jval.2017.12.010
Abstrakt: The fifth section of our Special Task Force report identifies and discusses two aggregation issues: 1) aggregation of cost and benefit information across individuals to a population level for benefit plan decision making and 2) combining multiple elements of value into a single value metric for individuals. First, we argue that additional elements could be included in measures of value, but such elements have not generally been included in measures of quality-adjusted life-years. For example, we describe a recently developed extended cost-effectiveness analysis (ECEA) that provides a good example of how to use a broader concept of utility. ECEA adds two features-measures of financial risk protection and income distributional consequences. We then discuss a further option for expanding this approach-augmented CEA, which can introduce many value measures. Neither of these approaches, however, provide a comprehensive measure of value. To resolve this issue, we review a technique called multicriteria decision analysis that can provide a comprehensive measure of value. We then discuss budget-setting and prioritization using multicriteria decision analysis, issues not yet fully resolved. Next, we discuss deliberative processes, which represent another important approach for population- or plan-level decisions used by many health technology assessment bodies. These use quantitative information on CEA and other elements, but the group decisions are reached by a deliberative voting process. Finally, we briefly discuss the use of stated preference methods for developing "hedonic" value frameworks, and conclude with some recommendations in this area.
(Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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