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Approaches to Aggregation and Decision Making-A Health Economics Approach: An ISPOR Special Task Force Report [5]
Charles E Phelps1, Darius N Lakdawalla2, Anirban Basu3
1Economics, Public Health Sciences, Political Science, University of Rochester, Gualala, CA, USA.
Summary
This report addresses challenges in aggregating cost-benefit data for health plan decisions. It explores methods like extended cost-effectiveness analysis and multicriteria decision analysis to better measure value.
Area of Science:
- Health economics
- Decision science
- Health technology assessment
Background:
- Current value assessment methods, such as quality-adjusted life-years, often exclude crucial cost and benefit data.
- There is a need to aggregate individual-level data to population levels for effective health plan decision-making.
- Combining diverse value elements into a single metric for individuals presents significant challenges.
Purpose of the Study:
- To identify and discuss aggregation issues in health economic evaluations.
- To explore advanced methods for incorporating broader value measures beyond traditional cost-effectiveness analysis.
- To review techniques for comprehensive value assessment and decision-making in health.
Main Methods:
- Extended Cost-Effectiveness Analysis (ECEA) to incorporate financial risk protection and income distribution.
- Augmented Cost-Effectiveness Analysis (CEA) for introducing multiple value measures.
- Multicriteria Decision Analysis (MCDA) for comprehensive value assessment and prioritization.
- Deliberative processes used by health technology assessment bodies.
- Stated preference methods for developing hedonic value frameworks.
Main Results:
- ECEA offers a broader utility concept by including financial risk protection and income distributional consequences.
- Augmented CEA can incorporate numerous value measures but does not provide a comprehensive value metric.
- Multicriteria Decision Analysis (MCDA) offers a comprehensive approach to value measurement and has potential for budget-setting and prioritization.
- Deliberative processes provide a framework for group decision-making using quantitative data.
Conclusions:
- Existing methods for measuring health value have limitations in aggregation and comprehensiveness.
- Multicriteria Decision Analysis (MCDA) and deliberative processes are promising approaches for population-level health decisions.
- Further research and recommendations are needed for developing robust value frameworks in health economics.
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