In This Week’s Issue:
1. PIPC Publishes Brief on Uses and Misuses of the QALY - Ethical Issues and Alternative Measures of Value, click here to view.
2. ICER’s Revised Value Assessment Framework released, click here to read the NPC blog.
3. PIPC Comments on LAN's Updated APM Framework, click here to read the letter.
4. Take the iHOPE Hospital Questions Survey: Have you ever left the hospital with unanswered questions? Click here to complete the survey.
5. Ipsen: PIPC Participates in Dialogue for Patient Care, click here to view the report.
6. Lupus: Patient-Focused Drug Development Meeting, click here to register.
7. Health Affairs: At Drug Hearing, Senators Discuss Meanings Of Price And Value—And Debate Health Reform, click here to view the article.
8. Epilepsy Foundation: 2017-2018 AAHD Frederick J. Krause Scholarship on Health and Disability, click here to apply.
9. Upcoming Events and Webinars, see details below
10. Medical Journal Articles, see details below.
11. AHRQ Effective Program Updates, see details below.
1. PIPC Publishes Brief on Uses and Misuses of the QALY - Ethical Issues and Alternative Measures of Value, click here to view.
2. ICER’s Revised Value Assessment Framework released, click here to read the NPC blog.
3. PIPC Comments on LAN's Updated APM Framework, click here to read the letter.
4. Take the iHOPE Hospital Questions Survey: Have you ever left the hospital with unanswered questions? Click here to complete the survey.
5. Ipsen: PIPC Participates in Dialogue for Patient Care, click here to view the report.
6. Lupus: Patient-Focused Drug Development Meeting, click here to register.
7. Health Affairs: At Drug Hearing, Senators Discuss Meanings Of Price And Value—And Debate Health Reform, click here to view the article.
8. Epilepsy Foundation: 2017-2018 AAHD Frederick J. Krause Scholarship on Health and Disability, click here to apply.
9. Upcoming Events and Webinars, see details below
10. Medical Journal Articles, see details below.
11. AHRQ Effective Program Updates, see details below.
1. PIPC Publishes Brief on Uses and Misuses of the QALY - Ethical Issues and Alternative Measures of Value
Last week, PIPC published an issue brief on Uses and Misuses of the QALY - Ethical Issues and Alternative Measures of Value. Value assessment in general, and the use of cost-effectiveness in particular, is receiving renewed interest as a tool for controlling health care spending. Currently, the most common method for determining incremental cost-effectiveness of healthcare interventions is based on a calculation of quality-adjusted-life-years (QALY). While the model has a basic appeal for making population-level decisions (by reducing patient populations to single, aggregate numeric values), it also poses several significant concerns from the vantage point of patient-centeredness and efforts to preserve access to needed care for individual patients and people with disabilities.
In particular, QALYs are:
2. ICER’s Revised Value Assessment Framework Released
Last week, the Institute for Clinical Economic Review (ICER) released its final Value Assessment Framework, a conceptual framework and set of associated methods that guide the development of ICER evidence reports. As part of the comment period ending April 3, 2017, the Partnership to Improve Patient Care (PIPC) provided numerous suggestions urging ICER to formalize a meaningful patient engagement process within ICER’s value framework and refrain from discriminatory cost-per-QALY based value determinations, among other suggestions. Problems with cost-effectiveness thresholds were highlighted in a new issue brief published this week by PIPC on Uses and Misuses of QALYs and potential alternative methods that are more patient-centered.
PIPC Chairman Tony Coelho provided the following statement in response to ICER’s final framework, "Amidst the debate about assessing and measuring the value of interventions and treatments, it is important to remember the reason we are having those conversations – the patient. We all want good value in health care. Unfortunately, by continuing to rely on one-size-fits-all cost/QALY standards, this final ICER value assessment framework falls short of patient-centeredness. Instead it continues to embrace the use of quality-adjusted-life-years, and thereby risks impeding patient access by encouraging payers to impose blunt, one-size-fits all standards on patient-provider decision-making.”
The National Pharmaceutical Council also offered its take on ICER’s revised value assessment framework. “NPC appreciates that ICER's revised framework incorporates many of the suggestions we put forth in our comments...However, NPC remains concerned about several key provisions that ICER has not addressed.” Click here to read the blog.
3. PIPC Comments on LAN's Updated APM Framework
In a letter to the Health Care Payment and Learning Action Network’s (LAN), PIPC applauds revisions made in the second draft of their Alternative Payment Model (APM) framework, while also raising concerns about the process and timeline to provide input. In the letter PIPC supports the fact that the new draft does not rely on cost effectiveness reports as a pillar for defining patient-centeredness in APMs. Additionally, PIPC strongly supports revisions made to move beyond damaging cost-effectiveness thresholds, and appreciates LAN's recognition of the importance of considering the risk of unintended consequences in APM design. Click here to read the letter.
4. Take the iHOPE Hospital Questions Survey: Have you ever left the hospital with unanswered questions?
The Improving Hospital Outcomes through Patient Engagement (iHOPE) Steering Committee needs participants for a survey that will help research teams learn the questions that patients, families, caregivers, and other healthcare stakeholders want answered. “Are you a healthcare provider or a member of a healthcare-related organization? Are there any uncertainties about patient care during and after the hospital stay, or areas where you feel there should be more evidence to guide care? This could include any aspect of care - treatments, processes, decision-making, discharge planning, etc. “ Click here to complete the survey.
5. Ipsen: PIPC Participates in Dialogue for Patient Care
To hear their point of view, Ipsen CEO David Meek sat down with three patient advocates from the United States and Europe on March 13, 2017. Participants could discuss such critical issues as patient empowerment, patient-centered research, involving patients in the drug development process, access to innovative drugs and the role of real-world data. PIPC Chairman Sara van Geertruyden joined the discussion, stating, "Our goal is to have decision- makers look at the value of healthcare in a context that better reflects what patients want to achieve.” Click here to view the report.
6. Lupus: Patient-Focused Drug Development Meeting
On September 25, 2017, 10:00 am - 4:00 pm at the College Park Marriott Hotel & Conference Center, the FDA will hold a Patient-Focused Drug Development meeting to advance their understanding of the lupus patient perspective. The goal of the Lupus PFDD Meeting is to inform how FDA officials – particularly those reviewing potential new treatments for lupus – think about this disease. We want agency officials to know what it is like to live with lupus day-in and day-out, how the disease impacts your daily life, what benefits you expect in future treatments and what level of risk you may be willing to accept in exchange for these benefits. Following the meeting, the organizers will write a report summarizing the survey results and the meeting, calling out the most important points and perspectives. This document will be conveyed to the FDA, pharmaceutical developers and researchers to ensure they know how lupus impacts people and families, what our community values most and what we want to see in new treatments. Click here to register!
7. Health Affairs: At Drug Hearing, Senators Discuss Meanings Of Price And Value—And Debate Health Reform
Rachel Sachs penned a piece for Health Affairs Blog on lawmaker optimism for value-based contracts for prescription drugs. “...Senators and panelists expressed optimism (sometimes cautious, sometimes not so much) about the possibility that value-based contracts for drugs may help achieve a number of benefits in the system. There’s just one problem: it wasn’t clear that everyone had the same idea of what “value-based pricing” was. This matters, because when Senators and panelists invoked particular benefits, those may be true of only some types of value-based contracts. Click here to view the article.
8. Epilepsy Foundation: 2017-2018 AAHD Frederick J. Krause Scholarship on Health and Disability
The American Association on Health and Disability’s Frederick J. Krause Scholarship on Health and Disability is currently accepting applications. The scholarship honors Frederick J. Krause, a lifelong advocate for those with disabilities who passed away in 2014. Beginning with his role as a special education teacher, Mr. Krause’s distinguished career in advocacy included service in the federal government and the cofounding of the American Association on Health and Disability. The scholarship pays tribute to Mr. Krause by awarding scholarships to students with disabilities that are pursuing an education on disability-related topics. Click here to apply.
9. Upcoming Events and Webinars
PCORI at AcademyHealth's Annual Research Meeting 2017
June 25-27, 2017
Click here for details.
The Seventh National Bundled Payment Summit
June 26-28, 2017
Click here for details.
Eugene Washington PCORI Engagement Awards: Key Information and Updates
June 27, 2017
Click here for details.
Bonnie: An eCQM Testing Tool.
June 28, 2017
Click here for details.
Facebook Live & Twitter Q&A: Men's Health Awareness Month
June 28, 2017
Click here for details.
PCORI and MHN Briefing on "What's the Right Decision for Me? Shared Decision Making in Prostate Cancer"
June 28, 2017
Click here for details.
Turning the Tide Against Cancer Through Sustained Medical Innovation 2017 National Conference
June 29, 2017
Click here for details.
PCORI Dissemination & Implementation Funding Opportunities Webinar
July 11, 2017
Click here for details.
Lupus Patient-Focused Drug Development (PFDD) Meeting
September 25, 2017
Click here for details.
Introduction to HEOR: Principles and Practice in Health Care Decision Making
October 5-8
Click here for details.
ASHRM 2017 Conference and Exhibition
October 15-18
Click here for details.
2017 PCORI Annual Meeting
October 31-November 2
Click here for details.
10. Medical Journal Articles
Attitudes Toward Comparative Effectiveness Research and Patient Engagement among Reproductive Health Clinicians, click here to view.
Patient Engagement in Patient-Centered Outcomes Research: Challenges, Facilitators and Actions to Strengthen the Field, click here to view.
Comparative effectiveness research: what to do when experts disagree about risks, click here to view.
Evidence Based Medicine Manifesto for Better Healthcare, click here to view.
A Retrospective Analysis of the Comparative Effectiveness of Smoking Cessation Medication Among Individuals with Mental Illness in Community-Based Mental Health and Addictions Treatment Settings, click here to view.
Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes, click here to view.
Experiences in Adapting European Network for Health Technology Assessment Rapid Reviews to Inform Local Decision Making, click here to view.
Impact of a Value-Based Insurance Design for Physical Therapy to Treat Back Pain on Care Utilization and Cost, click here to view.
Visions of Stakeholders about Instutionalization of Health Technology Assessment in Chile: S Qualitative Study, click here to view.
Oncology Drugs for Orphan Indications: How Are HTA Processes Evolving for this Specific Drug Category, click here to view.
Delivery of Meaningful Cancer Care: A Retrospective Cohort Study Assessing Cost and Benefit with the ASCO and ESMO Frameworks, click here to view.
Harmonizing Health Technology Assessment Practices in University Hospitals: To What Extent Is the Mini-HTA Model Suitable in the French Context?, click here to view.
Developments in Value Frameworks to Inform the Allocation of Healthcare Resources, clickhere to view.
Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29,823 Patients With Schizophrenia, click here to view.
Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome, click here to view.
The Value of Pragmatic and Observational Studies in Health Care and Public Health, click here to view.
From Evidence-Based Medicine to Personalized Medicine, with Particular Emphasis on Drug-Safety Monitoring, click here to view.
Impact of a Value-Based Insurance Design for Physical Therapy to Treat Back Pain on Care Utilization and Cost, click here to view.
Value-Based Insurance Design Pharmacy Benefits for Children and Youth With Special Health Care Needs: Principles and Opportunities, click here to view.
Refining Our Understanding of Value-Based Insurance Design and High Cost Sharing on Children, click here to view.
11. AHRQ Effective Program Updates
Stroke Prevention in Atrial Fibrillation Patients: A Systematic Review Update, click here to view.
Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update, click here to view.
Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update -- Research Protocol, click here to view.
Drug Therapy for Early Rheumatoid Arthritis in Adults – An Update -- Research Protocol, clickhere to view.
Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD): A Systematic Review Update -- Research Protocol, click here to view
Tympanostomy Tubes in Children with Otitis Media -- Final Report, click here to view
Treatment of Osteoarthritis of the Knee: An Update Review -- Final Report, click here to view.
Assessment Tools for Palliative Care -- Final Report, click here to view.
Noninvasive, Nonpharmacological Treatment for Chronic Pain, click here to view.
The Role of Immunotherapy in the Treatment of Asthma, click here to view
Preventing Complications and Treating Symptoms of Diabetic Peripheral Neuropathy -- Final Report, click here to view.
Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma, clickhere to view.
Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia -- Final Report, click here to view
First- and Second-Generation Antipsychotics in Children and Young Adults: Systematic Review Update -- Final Report, click here to view.
Strategies for Improving the Lives of Women Aged 40 and Above Living With HIV/AIDS -- Disposition of Comments, click here to view.
Physiologic Predictors of the Need for Trauma Center Care: A Systematic Review -- Research Protocol, click here to view.
Last week, PIPC published an issue brief on Uses and Misuses of the QALY - Ethical Issues and Alternative Measures of Value. Value assessment in general, and the use of cost-effectiveness in particular, is receiving renewed interest as a tool for controlling health care spending. Currently, the most common method for determining incremental cost-effectiveness of healthcare interventions is based on a calculation of quality-adjusted-life-years (QALY). While the model has a basic appeal for making population-level decisions (by reducing patient populations to single, aggregate numeric values), it also poses several significant concerns from the vantage point of patient-centeredness and efforts to preserve access to needed care for individual patients and people with disabilities.
In particular, QALYs are:
- Heavily dependent on the measurement instrument being used;
- Intended as a theoretical tool for academic researchers, not for decision-making that will impact actual patient lives;
- Developed from population averages, and are not patient-centered; and
- Widely acknowledged by experts to discriminate against people with disabilities.
2. ICER’s Revised Value Assessment Framework Released
Last week, the Institute for Clinical Economic Review (ICER) released its final Value Assessment Framework, a conceptual framework and set of associated methods that guide the development of ICER evidence reports. As part of the comment period ending April 3, 2017, the Partnership to Improve Patient Care (PIPC) provided numerous suggestions urging ICER to formalize a meaningful patient engagement process within ICER’s value framework and refrain from discriminatory cost-per-QALY based value determinations, among other suggestions. Problems with cost-effectiveness thresholds were highlighted in a new issue brief published this week by PIPC on Uses and Misuses of QALYs and potential alternative methods that are more patient-centered.
PIPC Chairman Tony Coelho provided the following statement in response to ICER’s final framework, "Amidst the debate about assessing and measuring the value of interventions and treatments, it is important to remember the reason we are having those conversations – the patient. We all want good value in health care. Unfortunately, by continuing to rely on one-size-fits-all cost/QALY standards, this final ICER value assessment framework falls short of patient-centeredness. Instead it continues to embrace the use of quality-adjusted-life-years, and thereby risks impeding patient access by encouraging payers to impose blunt, one-size-fits all standards on patient-provider decision-making.”
The National Pharmaceutical Council also offered its take on ICER’s revised value assessment framework. “NPC appreciates that ICER's revised framework incorporates many of the suggestions we put forth in our comments...However, NPC remains concerned about several key provisions that ICER has not addressed.” Click here to read the blog.
3. PIPC Comments on LAN's Updated APM Framework
In a letter to the Health Care Payment and Learning Action Network’s (LAN), PIPC applauds revisions made in the second draft of their Alternative Payment Model (APM) framework, while also raising concerns about the process and timeline to provide input. In the letter PIPC supports the fact that the new draft does not rely on cost effectiveness reports as a pillar for defining patient-centeredness in APMs. Additionally, PIPC strongly supports revisions made to move beyond damaging cost-effectiveness thresholds, and appreciates LAN's recognition of the importance of considering the risk of unintended consequences in APM design. Click here to read the letter.
4. Take the iHOPE Hospital Questions Survey: Have you ever left the hospital with unanswered questions?
The Improving Hospital Outcomes through Patient Engagement (iHOPE) Steering Committee needs participants for a survey that will help research teams learn the questions that patients, families, caregivers, and other healthcare stakeholders want answered. “Are you a healthcare provider or a member of a healthcare-related organization? Are there any uncertainties about patient care during and after the hospital stay, or areas where you feel there should be more evidence to guide care? This could include any aspect of care - treatments, processes, decision-making, discharge planning, etc. “ Click here to complete the survey.
5. Ipsen: PIPC Participates in Dialogue for Patient Care
To hear their point of view, Ipsen CEO David Meek sat down with three patient advocates from the United States and Europe on March 13, 2017. Participants could discuss such critical issues as patient empowerment, patient-centered research, involving patients in the drug development process, access to innovative drugs and the role of real-world data. PIPC Chairman Sara van Geertruyden joined the discussion, stating, "Our goal is to have decision- makers look at the value of healthcare in a context that better reflects what patients want to achieve.” Click here to view the report.
6. Lupus: Patient-Focused Drug Development Meeting
On September 25, 2017, 10:00 am - 4:00 pm at the College Park Marriott Hotel & Conference Center, the FDA will hold a Patient-Focused Drug Development meeting to advance their understanding of the lupus patient perspective. The goal of the Lupus PFDD Meeting is to inform how FDA officials – particularly those reviewing potential new treatments for lupus – think about this disease. We want agency officials to know what it is like to live with lupus day-in and day-out, how the disease impacts your daily life, what benefits you expect in future treatments and what level of risk you may be willing to accept in exchange for these benefits. Following the meeting, the organizers will write a report summarizing the survey results and the meeting, calling out the most important points and perspectives. This document will be conveyed to the FDA, pharmaceutical developers and researchers to ensure they know how lupus impacts people and families, what our community values most and what we want to see in new treatments. Click here to register!
7. Health Affairs: At Drug Hearing, Senators Discuss Meanings Of Price And Value—And Debate Health Reform
Rachel Sachs penned a piece for Health Affairs Blog on lawmaker optimism for value-based contracts for prescription drugs. “...Senators and panelists expressed optimism (sometimes cautious, sometimes not so much) about the possibility that value-based contracts for drugs may help achieve a number of benefits in the system. There’s just one problem: it wasn’t clear that everyone had the same idea of what “value-based pricing” was. This matters, because when Senators and panelists invoked particular benefits, those may be true of only some types of value-based contracts. Click here to view the article.
8. Epilepsy Foundation: 2017-2018 AAHD Frederick J. Krause Scholarship on Health and Disability
The American Association on Health and Disability’s Frederick J. Krause Scholarship on Health and Disability is currently accepting applications. The scholarship honors Frederick J. Krause, a lifelong advocate for those with disabilities who passed away in 2014. Beginning with his role as a special education teacher, Mr. Krause’s distinguished career in advocacy included service in the federal government and the cofounding of the American Association on Health and Disability. The scholarship pays tribute to Mr. Krause by awarding scholarships to students with disabilities that are pursuing an education on disability-related topics. Click here to apply.
9. Upcoming Events and Webinars
PCORI at AcademyHealth's Annual Research Meeting 2017
June 25-27, 2017
Click here for details.
The Seventh National Bundled Payment Summit
June 26-28, 2017
Click here for details.
Eugene Washington PCORI Engagement Awards: Key Information and Updates
June 27, 2017
Click here for details.
Bonnie: An eCQM Testing Tool.
June 28, 2017
Click here for details.
Facebook Live & Twitter Q&A: Men's Health Awareness Month
June 28, 2017
Click here for details.
PCORI and MHN Briefing on "What's the Right Decision for Me? Shared Decision Making in Prostate Cancer"
June 28, 2017
Click here for details.
Turning the Tide Against Cancer Through Sustained Medical Innovation 2017 National Conference
June 29, 2017
Click here for details.
PCORI Dissemination & Implementation Funding Opportunities Webinar
July 11, 2017
Click here for details.
Lupus Patient-Focused Drug Development (PFDD) Meeting
September 25, 2017
Click here for details.
Introduction to HEOR: Principles and Practice in Health Care Decision Making
October 5-8
Click here for details.
ASHRM 2017 Conference and Exhibition
October 15-18
Click here for details.
2017 PCORI Annual Meeting
October 31-November 2
Click here for details.
10. Medical Journal Articles
Attitudes Toward Comparative Effectiveness Research and Patient Engagement among Reproductive Health Clinicians, click here to view.
Patient Engagement in Patient-Centered Outcomes Research: Challenges, Facilitators and Actions to Strengthen the Field, click here to view.
Comparative effectiveness research: what to do when experts disagree about risks, click here to view.
Evidence Based Medicine Manifesto for Better Healthcare, click here to view.
A Retrospective Analysis of the Comparative Effectiveness of Smoking Cessation Medication Among Individuals with Mental Illness in Community-Based Mental Health and Addictions Treatment Settings, click here to view.
Comparative Effectiveness and Costs of Insulin Pump Therapy for Diabetes, click here to view.
Experiences in Adapting European Network for Health Technology Assessment Rapid Reviews to Inform Local Decision Making, click here to view.
Impact of a Value-Based Insurance Design for Physical Therapy to Treat Back Pain on Care Utilization and Cost, click here to view.
Visions of Stakeholders about Instutionalization of Health Technology Assessment in Chile: S Qualitative Study, click here to view.
Oncology Drugs for Orphan Indications: How Are HTA Processes Evolving for this Specific Drug Category, click here to view.
Delivery of Meaningful Cancer Care: A Retrospective Cohort Study Assessing Cost and Benefit with the ASCO and ESMO Frameworks, click here to view.
Harmonizing Health Technology Assessment Practices in University Hospitals: To What Extent Is the Mini-HTA Model Suitable in the French Context?, click here to view.
Developments in Value Frameworks to Inform the Allocation of Healthcare Resources, clickhere to view.
Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29,823 Patients With Schizophrenia, click here to view.
Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome, click here to view.
The Value of Pragmatic and Observational Studies in Health Care and Public Health, click here to view.
From Evidence-Based Medicine to Personalized Medicine, with Particular Emphasis on Drug-Safety Monitoring, click here to view.
Impact of a Value-Based Insurance Design for Physical Therapy to Treat Back Pain on Care Utilization and Cost, click here to view.
Value-Based Insurance Design Pharmacy Benefits for Children and Youth With Special Health Care Needs: Principles and Opportunities, click here to view.
Refining Our Understanding of Value-Based Insurance Design and High Cost Sharing on Children, click here to view.
11. AHRQ Effective Program Updates
Stroke Prevention in Atrial Fibrillation Patients: A Systematic Review Update, click here to view.
Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update, click here to view.
Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update -- Research Protocol, click here to view.
Drug Therapy for Early Rheumatoid Arthritis in Adults – An Update -- Research Protocol, clickhere to view.
Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD): A Systematic Review Update -- Research Protocol, click here to view
Tympanostomy Tubes in Children with Otitis Media -- Final Report, click here to view
Treatment of Osteoarthritis of the Knee: An Update Review -- Final Report, click here to view.
Assessment Tools for Palliative Care -- Final Report, click here to view.
Noninvasive, Nonpharmacological Treatment for Chronic Pain, click here to view.
The Role of Immunotherapy in the Treatment of Asthma, click here to view
Preventing Complications and Treating Symptoms of Diabetic Peripheral Neuropathy -- Final Report, click here to view.
Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma, clickhere to view.
Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia -- Final Report, click here to view
First- and Second-Generation Antipsychotics in Children and Young Adults: Systematic Review Update -- Final Report, click here to view.
Strategies for Improving the Lives of Women Aged 40 and Above Living With HIV/AIDS -- Disposition of Comments, click here to view.
Physiologic Predictors of the Need for Trauma Center Care: A Systematic Review -- Research Protocol, click here to view.
