Determining Value in Health Technology Assessment: Stay the Course or Tack Away?

Journal article

Publication Details

Author(s): Caro JJ, Brazier JE, Karnon J, Kolominsky-Rabas P, McGuire AJ, Nord E, Schlander M
Journal: Pharmacoeconomics
Publication year: 2019
Volume: 37
Journal issue: 3
Pages range: 293-299
ISSN: 1170-7690


The economic evaluation of new health technologies to assess whether the value of the expected health benefits warrants the proposed additional costs has become an essential step in making novel interventions available to patients. This assessment of value is problematic because there exists no natural means to measure it. One approach is to assume that society wishes to maximize aggregate health, measured in terms of quality-adjusted life-years (QALYs). Commonly, a single 'cost-effectiveness' threshold is used to gauge whether the intervention is sufficiently efficient in doing so. This approach has come under fire for failing to account for societal values that favor treating more severe illness and ensuring equal access to resources, regardless of pre-existing conditions or capacity to benefit. Alternatives involving expansion of the measure of benefit or adjusting the threshold have been proposed and some have advocated tacking away from the cost per QALY entirely to implement therapeutic area-specific efficiency frontiers, multicriteria decision analysis or other approaches that keep the dimensions of benefit distinct and value them separately. In this paper, each of these alternative courses is considered, based on the experiences of the authors, with a view to clarifying their implications.

FAU Authors / FAU Editors

Kolominsky-Rabas, Peter Prof. Dr. med.
Medizinische Fakultät

Additional Organisation
Interdisziplinäres Zentrum für Public Health

External institutions with authors

Deutsches Krebsforschungszentrum (DKFZ)
Norwegian Institute of Public Health (NIPH) / Folkehelseinstituttet
The London School of Economics and Political Science
University of Adelaide
University of Sheffield

How to cite

Caro, J.J., Brazier, J.E., Karnon, J., Kolominsky-Rabas, P., McGuire, A.J., Nord, E., & Schlander, M. (2019). Determining Value in Health Technology Assessment: Stay the Course or Tack Away? Pharmacoeconomics, 37(3), 293-299.

Caro, J. Jaime, et al. "Determining Value in Health Technology Assessment: Stay the Course or Tack Away?" Pharmacoeconomics 37.3 (2019): 293-299.


Last updated on 2019-28-03 at 09:38