title: Use of Value of Information in Healthcare Decision Making: Exploring Multiple Perspectives.
abstract: BACKGROUND
  Value of information (VOI) is a tool that can be used to inform decisions concerning additional research in healthcare. VOI estimates the value of obtaining additional information and indicates the optimal design for additional research. Although it is recognized as good practice in handling uncertainty, it is still hardly used in decision making in the Netherlands.
  
  
  OBJECTIVE
  This paper aims to examine the potential value of VOI, barriers and facilitators and the way forward with the use of VOI in the decision-making process for reimbursement of pharmaceuticals in the Netherlands.
  
  
  METHODS
  Three focus group interviews were conducted with researchers, policy makers, and representatives of pharmaceutical companies.
  
  
  RESULTS
  The results revealed that although all stakeholders recognize the relevance of VOI, it is hardly used and many barriers to the performance and use of VOI were identified. One of these barriers is that not all uncertainties are easily incorporated in VOI, and the results may be biased if structural uncertainties are ignored. Furthermore, not all research designs indicated by VOI may be feasible in practice.
  
  
  CONCLUSIONS
  To fully embed VOI into current decision-making processes, a threshold incremental cost-effectiveness ratio and guidelines that clarify when and how VOI should be performed are needed. In addition, it should be clear to all stakeholders how the results of VOI are used in decision making.
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. jill.bindels@mumc.nl.
authors.forename: Jill
authors.initials: J
authors.lastname: Bindels
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: Ramaekers
authors.affiliation: Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Isaac Corro
authors.initials: IC
authors.lastname: Ramos
authors.affiliation: Creativ-Ceutical, Rotterdam, The Netherlands.
authors.forename: Leyla
authors.initials: L
authors.lastname: Mohseninejad
authors.affiliation: National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Knies
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Grutters
authors.affiliation: Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.|Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Postma
authors.affiliation: Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Maiwenn
authors.initials: M
authors.lastname: Al
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.|National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Talitha
authors.initials: T
authors.lastname: Feenstra
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Manuela
authors.initials: M
authors.lastname: Joore
mesh_terms: D000066491:Clinical Decision-Making; D003362:Cost-Benefit Analysis / Q000379:methods*; D003661:Decision Support Techniques; D017144:Focus Groups; D006801:Humans; D009426:Netherlands; D012107:Research Design; D035501:Uncertainty