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Stakeholder opinions on value in healthcare
  1. Robert Terkola1,2,3,
  2. Fernando Antoñanzas4,
  3. Maarten Postma2,5,6
  1. 1College of Pharmacy, Department of Pharmacotherapy and Translational Research, Experiental Programs, University of Florida, Gainesville, Florida, USA
  2. 2Department of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics (PTE2), University of Groningen, Groningen, Netherlands
  3. 3Pharmacy, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
  4. 4Department of Economics, University of La Rioja, Logrono, Spain
  5. 5Institute of Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  6. 6Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  1. Correspondence to Dr Robert Terkola, Landesklinikum Wiener Neustadt, Pharmacy, Erwin Schrödinger Straße 4, 2700 Wiener Neustadt, Austria; robert.terkola{at}wienerneustadt.lknoe.at

Abstract

Objectives To determine how the value of new medicines is defined from the perspective of different stakeholders in nine European countries.

Methods We carried out an explorative survey by conducting in-depth qualitative interviews with a range of experts with health technology assessment, clinical provision, health economics, payer, academic and industry experience. Experts were asked to distribute 100 points over a predefined list of attributes related to value. In total, 30 interviews were conducted with seven academics, five clinicians, nine economists, five payers and four providers. Each of these categories was represented in responses from France, Germany, the Netherlands and the UK.

Results Comments on the interview guide were all positive. There was substantial variation in definitions of value provided by respondents. Most respondents indicated that delivering benefits to the patient is a prerequisite for a healthcare product to be of value, but only half included costs or resource use in their definition. Quantitative responses showed that effectiveness and efficacy were considered the most important attributes of value, followed by safety and side effects. Lower scores were given to other attributes, such as dignity and individualism, and invasiveness of the treatment. Resources and costs associated with complications and readmissions were considered important by academics and economists, but not clinicians.

Conclusions The interview findings indicate that the value of a drug is subjective in being perceived differently by different stakeholders, and for different treatment types. Future research will require evaluation of the views of a larger number of stakeholders in more and different countries to confirm these findings.

  • pharmacoeconomics
  • expert opinion
  • value
  • health care
  • europe
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