TY - JOUR
T1 - Social value and individual choice
T2 - The value of a choice-based decision-making process in a collectively funded health system
AU - Espinoza, Manuel Antonio
AU - Manca, Andrea
AU - Claxton, Karl
AU - Sculpher, Mark
N1 - Funding Information:
This research was funded by the UK Department of Health Policy Research Programme through its Policy Research Unit in Economic Evaluation of Health and Care Interventions (EEPRU). The views expressed are not necessarily those of the Department. M. E. has received doctoral funding from the Chilean scholarship program “Beca Presidente de la República” and the School of Medicine at Pontificia Universidad Católica de Chile. A. M.′s contribution was made under the terms of a career development research training fellowship issued by the National Institute for Health Research (Grant CDF‐2009‐02‐21). We would like to acknowledge collaborators on the RITA‐3 trial economic analysis.
Funding Information:
UK Department of Health Policy Research Programme through its Policy Research Unit in Economic Evaluation of Health & Care Interventions (EEPRU); National Institute for Health Research, Grant/ Award Number: CDF‐2009‐02‐21; Chilean scholarship program “Beca Presidente de la República”
Publisher Copyright:
Copyright © 2017 John Wiley & Sons, Ltd.
PY - 2018/2
Y1 - 2018/2
N2 - Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system.
AB - Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system.
UR - http://www.scopus.com/inward/record.url?scp=85044455837&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/28975685
U2 - 10.1002/hec.3559
DO - 10.1002/hec.3559
M3 - Article
C2 - 28975685
AN - SCOPUS:85044455837
SN - 1057-9230
VL - 27
SP - e28-e40
JO - Health Economics (United Kingdom)
JF - Health Economics (United Kingdom)
IS - 2
ER -