Home Health Is worth within the eye of the beholder? Worth frameworks and inter-rater reliability – Healthcare Economist
Health - April 14, 2021

Is worth within the eye of the beholder? Worth frameworks and inter-rater reliability – Healthcare Economist

A brand new drug comes in the marketplace. Is the well being profit value the fee? What’s it’s worth? Worth evaluation frameworks are one strategy to reply this query. Worth frameworks take the proof of the therapies advantages, threat and value and output some notion of the remedy’s worth. Ideally, if anybody utilized a given worth framework, they might get the identical or a minimum of related solutions concerning the therapies true worth. However is that the case in follow?

A paper by Karas et al. (2021) goals to offer the reply. The authors carried out a retrospective, observational research at a single well being system. They look at how three people–a fourth-year pharmacy scholar, a drug data resident, and a drug data pharmacist–utilized the worth evaluation frameworks to the identical drug. The worth evaluation frameworks evaluated had been three oncology-specific worth frameworks (i.e., ASCO, ESMO, and NCCN) and two non-oncology (the ACC/AHA framework and the ICER calculation). The important thing statistical measure of curiosity was the intraclass correlation coefficient (ICC), which was used to measure inter-rater reliability. Utilizing this strategy as utilized to 94 medicines, the authors discovered that:

…[t]he VAFs [value assessment frameworks] with the very best ICCs between all 3 raters had been NCCN (0.635; 95% CI = 0.387-0.823) and ASCO (0.634; 95% CI = 0.370-0.832), each indicating reasonable inter-rater reliability. The VAFs with the bottom ICCs had been ESMO (0.368; 95% CI = 0.126-0.611) and ICER (0.159; 95% = CI −0.018-0.365), with ICCs comparable to poor reliability.

This doesn’t essentially imply that NCCN and ASCO are ‘higher’ as a quite simple worth framework could also be simple to make use of and have ICC, however it could miss many worth components. The incremental price effectiveness ratio (ICER) strategy has the benefit of being very flexibility to completely different illness areas, however–seemingly partly on account of this flexibility–it may be utilized otherwise by completely different people.


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