Patient-centric HTA: different strokes for different folks

Abstract

Patient centricity will initiate a change in healthcare decision-making paradigms. Patient-centered outcomes are a part of the solution to the challenges posed by complex decision problems due to multiple clinical and non-clinical outcomes. Multiple decision criteria require that clinical and regulatory decisions be based on the implicit value judgments of experts. Experts are under continuous pressure to ensure decisions are aligned with patient needs and result in positive performance. To fulfill this role and guarantee efficient decisions, experts must be fully informed about patient preferences; however, this assumption might not necessarily reflect reality. Health technology assessment focuses on the measurement of clinical effects, rather than the assessment of the impact of different outcomes on users' perceived value. Further evidence is needed to ensure that expert judgments are congruent with patient preferences. Therefore, patient preferences can be a valuable source of information to inform clinical and regulatory decision-makers.

Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

“…This recommendation does not preclude investigators from exploring new ways to analyze and disseminate the results of CEA. In fact, there is a great deal of discussion regarding alternatives to this single endpoint approach [52][53][54]. We argue, thanks to suggestions from individuals with lived experience with HCV, CEAs for interventions in HCV should go beyond this starting point by including multiple denominators for comparison.…”

Incorporating Quantitative Patient Preference Data into Healthcare Decision Making Processes: Is HTA Falling Behind?

“…In contrast to what is happening in the regulatory space, consideration of how to formally incorporate patient preference data into HTAs appears to be in its infancy [22], despite persistent calls for patient-centric HTA [25,26]. There are several potential reasons for why this might be the case, which are outlined in turn.…”

“…Incorporating the ''patient voice'' into HTA is desirable [25], but doing so quantitatively is clearly a challenge given the current landscape. What changes might be needed for it to be possible for HTA to catch up with the regulatory space in this regard?…”

Choice Experiments to Quantify Preferences for Health and Healthcare: State of the Practice

“…The extent to which people are willing to pay for rising healthcare expenditures or patients prefer an alternative use of resources, however, remains largely unexplored in this debate. Implementation of patient-centred healthcare systems and meaningful incorporation of people's priorities in healthcare decision making requires methods for quantifying patients' preferences [18].…”