Objectives, Budgets, Thresholds, and Opportunity Costs-A Health Economics Approach: An ISPOR Special Task Force Report [4

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Patricia M DanzonM V Pauly

Abstract

The fourth section of our Special Task Force report focuses on a health plan or payer's technology adoption or reimbursement decision, given the array of technologies, on the basis of their different values and costs. We discuss the role of budgets, thresholds, opportunity costs, and affordability in making decisions. First, we discuss the use of budgets and thresholds in private and public health plans, their interdependence, and connection to opportunity cost. Essentially, each payer should adopt a decision rule about what is good value for money given their budget; consistent use of a cost-per-quality-adjusted life-year threshold will ensure the maximum health gain for the budget. In the United States, different public and private insurance programs could use different thresholds, reflecting the differing generosity of their budgets and implying different levels of access to technologies. In addition, different insurance plans could consider different additional elements to the quality-adjusted life-year metric discussed elsewhere in our Special Task Force report. We then define affordability and discuss approaches to deal with it, including consideration of disinvestment and related adjustment costs, the impact of delaying ...Continue Reading

Citations

Feb 21, 2019·Journal of Managed Care & Specialty Pharmacy·Louis P GarrisonMike Kenston
Feb 17, 2019·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Michael Drummond, Adrian Towse
Jun 15, 2019·Journal of Medical Economics·Lieven Annemans
Nov 30, 2019·Journal of Managed Care & Specialty Pharmacy·Andrew P BroganAllan Coukell
Apr 1, 2020·Journal of Managed Care & Specialty Pharmacy·Louis P GarrisonAdrian Towse
Sep 22, 2020·Expert Review of Pharmacoeconomics & Outcomes Research·Jessica OchalekKimberly M Thompson
Dec 4, 2019·PharmacoEconomics·T Joseph MattinglyC Daniel Mullins
Sep 27, 2019·Journal of Managed Care & Specialty Pharmacy·Louis P Garrison, Adrian Towse
Nov 3, 2020·Annals of Internal Medicine·David J VannessHannah Ahn
Mar 6, 2021·Journal of Comparative Effectiveness Research·Saskia Hendriks, Steven D Pearson
Jul 11, 2021·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Giulia FornaroOriana Ciani
Jul 16, 2021·International Journal of Technology Assessment in Health Care·Rebecca TrowmanDaniel A Ollendorf
Nov 1, 2020·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Steven ForsytheAnthony Kinghorn

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