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• W4220921286 abstract "We welcome the publication by Walraven et al1Walraven J. Jacobs M.S. Uyl-de Groot C.A. Leveraging the similarities between cost-effectiveness analysis and value-based healthcare.Value Health. 2021; 24: 1038-1044Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar that highlights the similarities between cost-effectiveness analysis (CEA) and value-based healthcare (VBHC) and proposes a method to integrate VBHC into CEA through a so-called VBHC quality-adjusted life-year (QALY). We fully support the authors in their view that CEA and VBHC can learn from one another. On the one hand, VBHC may learn from the well-established field of CEA in terms of study designs and analysis. Requirements for the design and analysis of economic evaluations scaffold the validity and generalizability of results,2Guideline for conducting economic evaluations in healthcare [Richtlijn voor het uitvoeren van economische evaluaties in de gezondheidszorg]. Zorginstituut Nederland.https://english.zorginstituutnederland.nl/publications/reports/2016/06/16/guideline-for-economic-evaluations-in-healthcareDate accessed: July 8, 2021Google Scholar as should also be the case for VBHC to be used as a robust methodology for comparing the value of treatments or care providers. On the other hand, CEA may learn from the patient-centeredness in outcome measurement in the emerging field of VBHC because the hardline CEA methodology might not capture all patient-relevant aspects of health or wellbeing.3Al-Janabi H. Flynn T.N. Coast J. Development of a self-report measure of capability wellbeing for adults: the ICECAP-A.Qual Life Res. 2012; 21: 167-176Crossref PubMed Scopus (349) Google Scholar The CEA methodology assesses new medical interventions from a societal perspective to support reimbursement decisions for national health insurance coverage. Because of that societal perspective, it is essential that CEAs use a standardized, normative cost-per-QALY framework that is transparent and equitable. Walraven et al1Walraven J. Jacobs M.S. Uyl-de Groot C.A. Leveraging the similarities between cost-effectiveness analysis and value-based healthcare.Value Health. 2021; 24: 1038-1044Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar attempt to fit VBHC into a similar framework by means of the VBHC-QALY, but we argue that VBHC does not aim to assess care in a normative, aggregate framework. VBHC calls for the reorganization of the current healthcare system into integrated practice units and the measurement of patient-relevant outcomes and costs to optimize value delivery.4Porter M.E. Lee T.H. The strategy that will fix health care.Hardvard Bus Rev. 2013; 91: 24PubMed Google Scholar The measurement of individual patient-relevant outcomes is essential for value delivery in 2 ways: first, by facilitating shared decision making among patient, family, and clinician to select the optimal treatment strategy based on the outcomes that matter most to the patient and, second, by facilitating the improvement and comparison of care paths through internal and external benchmarking of relevant outcome criteria. This individual and institutional perspective does not require a standardized QALY-like framework, given that individuals and institutions are free to choose their own interpretation of the data. In the sum of the weighted individual scores that makes up the proposed VBHC-QALY, valuable dimensions of outcome measurement are lost, which challenges the patient-centeredness of the VBHC-QALY. In addition, we expect that presenting the diverse criteria in a single index score will threaten the individuality of the patient in decision making and will threaten the identification of learning opportunities in benchmarking. Alternative to the integration of VBHC and CEA, we propose that VBHC and CEA are used to complement each other at their different levels of operation in healthcare—CEA on the societal (or macro) level to evaluate new medical interventions for reimbursement decisions and VBHC on the patient and organizational (micro and meso) levels to enhance shared decision making and stimulate care cycle improvement initiatives among other things. This difference in perspective between CEA and VBHC should be respected when identifying learning opportunities between the 2 methodologies. For example, the International Consortium for Health Outcomes Measurement validated standard sets also mentioned by Walraven et al1Walraven J. Jacobs M.S. Uyl-de Groot C.A. Leveraging the similarities between cost-effectiveness analysis and value-based healthcare.Value Health. 2021; 24: 1038-1044Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar,5Ong W.L. Schouwenburg M.G. van Bommel A.C.M. et al.A standard set of value-based patient-centered outcomes for breast cancer: the International Consortium for Health Outcomes Measurement (ICHOM) initiative.JAMA Oncol. 2017; 3: 677-685Crossref PubMed Scopus (132) Google Scholar, 6Oude Voshaar M.A.H. Das Gupta Z. Bijlsma J.W.J. et al.International consortium for health outcome measurement set of outcomes that matter to people living with inflammatory arthritis: consensus from an International Working Group.Arthritis Care Res (Hoboken). 2019; 71: 1556-1565Crossref PubMed Scopus (33) Google Scholar, 7Akpan A. Roberts C. Bandeen-Roche K. et al.Standard set of health outcome measures for older persons.BMC Geriatr. 2018; 18: 36Crossref PubMed Scopus (109) Google Scholar are a good start to harmonize outcome measurement globally and regard the perspective of the patient in benchmarking, thereby harboring the strengths of both CEA and VBHC. Author Contributions: Concept and design: van der Poort, Stiggelbout, van den Hout Drafting of the manuscript: van der Poort, van den Akker-van Marle, van den Hout Critical revision of the paper for important intellectual content: van der Poort, van den Akker-van Marle, Stiggelbout, van den Hout Obtaining funding: Stiggelbout Supervision: van den Akker-van Marle, van den Hout Conflict of Interest Disclosures: The authors reported no conflicts of interest. Funding/Support: The authors received no financial support for this research." @default.
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• W4220921286 title "Leveraging the Similarities Between Cost-Effectiveness Analysis and Value-Based Healthcare" @default.
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