title: Advancing Value Assessment in the United States: A Multistakeholder Perspective.
abstract: Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introduced recently to help providers, patients, and payers better understand the potential value of drugs and other interventions and make informed decisions about their use. Given their early stage of development, it is imperative to evaluate these efforts on an ongoing basis to identify how best to support and improve them moving forward. This article provides a multistakeholder perspective on the key limitations and opportunities posed by the current value assessment frameworks and areas of and actions for improvement. In particular, we outline 10 fundamental guiding principles and associated strategies that should be considered in subsequent iterations of the existing frameworks or by emerging initiatives in the future. Although value assessment frameworks may not be able to meet all the needs and preferences of stakeholders, we contend that there are common elements and potential next steps that can be supported to advance value assessment in the United States.
authors.affiliation: Duke Clinical Research Institute, Duke School of Medicine, Duke University, Durham, NC, USA. Electronic address: corinna.sorenson@duke.edu.
authors.forename: Corinna
authors.initials: C
authors.lastname: Sorenson
authors.affiliation: Duke-Robert J. Margolis, MD Center for Health Policy, Duke University, Durham, NC, USA.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Lavezzari
authors.affiliation: Duke-Robert J. Margolis, MD Center for Health Policy, Duke University, Durham, NC, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Daniel
authors.affiliation: Pharmaceutical Research and Manufacturers of America, Washington, DC, USA.
authors.forename: Randy
authors.initials: R
authors.lastname: Burkholder
authors.affiliation: National Health Council, Washington, DC, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Boutin
authors.affiliation: Enlightenment Bioconsult, LLC, Wethersfield, CT, USA.
authors.forename: Edmund
authors.initials: E
authors.lastname: Pezalla
authors.affiliation: Duke Clinical Research Institute, Duke School of Medicine, Duke University, Durham, NC, USA.
authors.forename: Gillian
authors.initials: G
authors.lastname: Sanders
authors.affiliation: Duke-Robert J. Margolis, MD Center for Health Policy, Duke University, Durham, NC, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: McClellan
mesh_terms: D017408:Guidelines as Topic; D005102:Health Expenditures; D058996:Quality Improvement; D013673:Technology Assessment, Biomedical / Q000592:standards*; D014481:United States; D062505:Value-Based Purchasing
keywords: health care decision makers; standards; value assessment; value for money