Why We Don’t Need “Unmet Needs”! On the Concepts of Unmet Need and Severity in Health-Care Priority Setting

Sandman, Lars; Hofmann, Bjørn

doi:10.1007/s10728-018-0361-2

Cited by 19 publications

(31 citation statements)

References 38 publications

(48 reference statements)

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“…Recently, the concept of condition severity was posed as a way to unify treatment availability and disease severity. 25 The proposal of those authors is to quantify the remaining unmet need through correcting for disease severity and available treatments in relation to a state of optimal health. 25 The authors of that study argue that condition severity should replace UMN altogether.…”

Section: Context and Implicationsmentioning

confidence: 99%

“…25 The proposal of those authors is to quantify the remaining unmet need through correcting for disease severity and available treatments in relation to a state of optimal health. 25 The authors of that study argue that condition severity should replace UMN altogether. 25 Our work has illustrated that different methods could define the relation between individual UMN elements.…”

Section: Context and Implicationsmentioning

confidence: 99%

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Unmet Medical Need: An Introduction to Definitions and Stakeholder Perceptions

Vreman

Heikkinen²,

Schuurman

et al. 2019

Value in Health

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Background: Despite increasing informal and formal use of unmet medical need (UMN) in drug development, regulation, and assessment, there is no insight into its definitions in use. This study aims to provide insight into the current definitions in use and to provide a starting point for a multi-stakeholder discussion on alignment. Methods: A scoping and a gray literature review were performed to locate definitions of UMN in literature and on stakeholder websites. These definitions were categorized and then discussed among the multi-stakeholder author group via semistructured group discussions and open session workshops with a broader stakeholder audience. Issues with the formation of a common definition and mechanisms for use were discussed. Results: The reviews yielded 16 definitions. Differences were evident, but all included 1 or more of the following elements: (adequacy of) available treatments (16 of 16: 100%), disease severity or burden (6 of 16: 38%), and patient population size (1 of 16: 6%). The stakeholder discussions led to a suggestion for a definition including the first 2 items and, depending on context, population size. The discussions also showed that quantification of UMN is highly dependent on the scope and the value framework in which it is used based on different stakeholder preferences and responsibilities. Conclusion: We encourage stakeholders that want to promote alignment on the concept of UMN to prospectively discuss the scope in which they want to apply the concept, what elements they find important for consideration in each case, and how they would measure UMN within the broader regulatory or value framework applicable.

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Section: Context and Implicationsmentioning

confidence: 99%

Section: Context and Implicationsmentioning

confidence: 99%

Unmet Medical Need: An Introduction to Definitions and Stakeholder Perceptions

Vreman

Heikkinen²,

Schuurman

et al. 2019

Value in Health

View full text Add to dashboard Cite

show abstract

“…If the severity of disease assesses the disease regardless of treatment status, and the severity of a condition is sensitive to whether the condition has been treated or not, this may have a major impact on priority setting decisions, e.g. in situations where there is ample access to treatments reducing the severity of the disease [98].…”

Section: Should It Be the Disease Or The Condition Of The Patient Thamentioning

confidence: 99%

“…It is important to establish whether the severity of a condition is subject to reassessment throughout the course of the disease. Another aspect of this is that if the severity of a condition approach is used, then treatment will affect the severity of the condition [98]. This implies that the order in which treatment are introduced might affect the actual prioritisation.…”

Section: How Should Severity Be Viewed From a Temporal Perspective?mentioning

confidence: 99%

Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda

et al. 2019

Self Cite

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Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today's severity criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda.

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“…The de nition of an "unmet need" varies among researchers [7]. However, according to the European parliament, an "unmet medical need" is a condition in which no satisfactory method of prevention, diagnosis, and treatment exists [8]. Between 2016 and 2017, the rates of unmet medical needs across 27 European countries declined from 2.6-1% [9].…”

Section: Introductionmentioning

confidence: 99%

Determining the reasons for unmet medical needs in Korea: A secondary data analysis

Ha¹,

Jung

2020

Preprint

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Background: Unmet medical need which are indicators used globally to assess healthcare accessibility is a condition in which no satisfactory method of prevention, diagnosis, and treatment exists. The purpose of this study is to analyze factors related to unmet medical needs among Korean adults. Methods: We used a retrospective cross-sectional study design. This nationwide-based study included the data of 26,598 participants aged 19 years and older, obtained from the Korea National Health and Nutrition Examination Survey for 2013–2017. Using multiple logistic regression models, we analyzed the associations between factors that influence unmet medical needs and participants’ subgroups.Results: Despite Korea’s universal health-insurance system, we found that in 2017, 9.5% of Koreans experienced unmet needs. In the young adult group, men had a higher odds ratio of experiencing unmet medical needs compared to women (Males: OR = 1.83, 95% CI = 1.35-2.48; Females: OR = 1.42, 95% CI = 1.12-1.81). ). In particular, unlike men, women’s unmet medical needs increased as their incomes decreased (1Q OR = 1.55, 2Q OR =1.29, 3Q OR=1.26). Men and women showed a tendency to have more unmet medical needs with less exercise, worse subjective health state, worse pain, and a higher degree of depression.Conclusions: In conclusion, unmet medical needs contributing factors included having a low socioeconomic status, high stress, severe pain, or severe depression. Considering our findings, we suggest improving health-care access with low socioeconomic status.

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Why We Don’t Need “Unmet Needs”! On the Concepts of Unmet Need and Severity in Health-Care Priority Setting

Cited by 19 publications

References 38 publications

Unmet Medical Need: An Introduction to Definitions and Stakeholder Perceptions

Unmet Medical Need: An Introduction to Definitions and Stakeholder Perceptions

Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda

Determining the reasons for unmet medical needs in Korea: A secondary data analysis

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