Chapter 9 introduces the reader to the stages of cost–benefit analysis (CBA) as specifically applied to public health intervention economic evaluation. The specific focus of this chapter follows on from the messages of Chapter 6 on the relevance of, and methods for, quantifying the ‘outcomes’ of public health interventions in monetary form for CBA. Two case studies focus on the use of stated preference discrete choice experiment (SPDCE) methodology for valuation of multi-attribute benefits comprising health, non-health, and process outcomes of the type likely to occur in PHIs.
books, reference lists). Database search terms did not generally use validated filters for study designs; many did not use any specific search terms for burden outcomes. Formal quality assessment was only performed in half of the included studies, using a variety of published checklists. ConClusions: The variation in approaches for conducting SLRs on burden of disease may make it difficult for policymakers to compare the results of SLRs in different disease areas. Consideration of the similarities and differences between the methodologies identified in this review will be useful to inform future SLRs.
A707 analysis of country specific legislation, government body requirements and recommendations. Results: Non-interventional studies collecting patient reported outcomes, preferences and perceptions of a disease and its treatment, require a formal review from an Ethic Committee (EC) in France, Germany and UK. In France, these studies involve human subjects and therefore require a formal review and approval from patient and data protection agencies. In Germany, they can be classified as an 'Anwendungsbeobachtung' and an EC review is highly recommended. In the UK, studies without 'material ethical issues' are suitable for a Proportionate Review instead of full REC. ConClusions: Considering the increasing demand and the extended benefits brought by these patient studies, we wonder why they are excluded from the upcoming regulation for a European harmonized process. We encourage legislators to extend the scope of this new regulation and offer a common and faster ethics review to facilitate the conduct of such studies without mitigating patient protection.
e18320 Background: A number of frameworks for assessing the value of cancer treatments such as the National Comprehensive Cancer Network’s evidence blocks, Memorial Sloan Kettering Cancer Center’s Drug Abacus and ASCO’s value framework have been developed to help address the rising cost of cancer treatments. Yet the methodological basis for the inclusion of differing attributes, how to incorporate other contextual considerations and understand stakeholder trade-offs is unclear. This qualitative study aimed to identify contextual factors prioritized by stakeholders for inclusion in oncology value frameworks. Methods: A scoping review identified attributes currently included in value frameworks. Nominal group technique methods were then used in 3 focus groups representing cancer patients, oncology nurses, and physicians across a range of cancer specialties. Each group was tasked with ‘identifying important treatment features’ based on their own experience. Following discussions, participants ranked attributes in order of importance and group consensus identified the ‘top 6’ factors. Results: Twenty-one attributes were identified by the patient (n = 9), nurse (n = 10) and physician (n = 6) focus groups. All identified efficacy and safety/toxicity. Long-term adverse effects, alternative treatment options, quality of evidence and reputation of the treating oncologist/center were prioritized by patients. Nurse preferences centered on mode of administration, quality of life, communication and treatment innovation. Physicians focused on the burden and inconvenience of treatments to patients, functional outcomes, financial toxicity to patients, and societal costs. Conclusions: Although efficacy and safety/toxicity were prioritized in all groups, the prioritization of contextual factors across stakeholders highlights the need to further understand the relative value of possible ‘other’ attributes currently not reflected in frameworks thus, possibly failing to reflect the preferences of stakeholders.
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