Health Economics, Health Policy and Healthcare Management

Biography

Biography: Thilo Schaufler

Abstract

Traditional frameworks to assess the value of therapeutic options do not provide a comprehensive picture of their full value for patients, health systems and the wider economy and society. This limited picture of value risks driving decision-making towards a narrow set of trade-offs within existing budgets instead of supporting additional investment in health overall.

We propose a novel Integrated Value Framework to provide the comprehensive understanding of value that can support engagement with policymakers across government to address such investment. We review existing frameworks such as those proposed by the ASCO and ESMO, and identify gaps in their coverage of value that are important for patients and for policy-makers. We propose two key methodological innovations. The first is to extend the scope of value assessment to capture benefits to the wider economy and society beyond health systems, such as those relating to jobs, welfare costs, social and family impacts for patients and informal caregivers, and scientific research, reflecting the recognition of the wider value of investment in health. The second is to capture both monetary and non-monetary dimensions of value, drawing on increasing attention to non-monetary elements of value and well-being at societal level. 

We discuss how this framework can help to improve decision-making at policy level by ensuring a better understanding of the full value of therapeutic options. This is important both in developing countries (with typically low levels of investment in health) and developed countries (where large overall budgets can mask limited flexibility to redirect funding towards greatest value).