Developing a Conceptual Framework for Patient-Centered Value and Health Technology Assessment

While patient-experience data (PED) are needed to inform value and health technology assessment (V/HTA), various existing conceptual frameworks, including economic, clinical outcomes assessment (COA), patient-focused drug development (PFDD), and patient centricity, can be leveraged to support patient-centered V/HTA. Leveraging these existing frameworks from different fields, this study aimed to develop a conceptual framework for data collection to inform patient-centered V/HTA.

Noting that a traditional keyword search strategy was not useful for identifying the target frameworks, expert input guided the search. Experts focused on 3 fields of interest—health economics, COA, and patient centricity—to identify frameworks. Frameworks were reviewed for aspects of patient centricity, value/economic relevancy, and their ability to address the following: patient populations, concepts of interest, context of use, item generation (if applicable), and final outputs. Concepts from the identified frameworks were combined to develop a patient-centered V/HTA framework.

Experts identified 8 conceptual frameworks, shown below.

Table

The combined framework proposed for patient-centered V/HTA leverages ISPOR Value Flower for economic elements and PAVE in bridging the economic and patient centricity gap. FDA Patient-Focused Outcome Measurement and FDA COA Qualification were leveraged to inform patient-derived concepts of interest. Meaningful patient engagement from PCORI, 10-step Patient Engagement Framework, FDA PFDD, and National Health Council Patient-Centered Value Rubric were also leveraged. The derived framework considered multiple diseases to identify patient-centered experiences to inform V/HTA.

The conceptual framework proposed provides a connection between patient centricity and economic assessment. This evolution in thinking, which supports patient-centered V/HTA, merges the conceptual basis of frameworks from multiple fields to fulfill an unmet need in patient-centered assessment.

Source:

Majercak K, Perfetto E, Slejko J. The interconnectivity of patient centricity and economic assessment: a conceptual framework to inform patient-centered value/health technology assessment. Presented at: 2022 Academy of Managed Care Pharmacy Nexus Annual Meeting; October 11-14, 2022; National Harbor, MD. Poster U14.

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