Capturing Patient Value in an Economic Evaluation
Fiona Koster, Marc R. Kok, Deirisa Lopes Barreto, Angelique E.A.M. Weel-Koenders
ECHORM's Febraury 2024 Journal Club
Fiona Koster is a PhD candidate conducting research in the field of Value-Based Healthcare (VBHC) at the rheumatology department of the Maasstad Hospital and Erasmus School of Health Policy and Management in Rotterdam, the Netherlands. She holds a bachelor’s degree in health sciences and a master’s degree in health economics. She was also one of the founding Executive Board Members of ECHORM.
Koster will discuss one of her papers, titled “Capturing Patient Value in an Economic Evaluation”, which presents the results of a study evaluating the possibility of using disease-specific measures in a cost-effectiveness analysis. We hope you can join us for what is sure to be an interesting discussion.
Economic evaluations predominantly use generic outcomes, such as the Euro Quality of Life-5 Dimension (EQ-5D), to assess health status. However, because of the generic nature, they are less suitable to capture the quality of life of patients with specific conditions. Given the transition to patient-centered (remote) care delivery, this study aims to evaluate the possibility of using disease-specific measures in a cost-effectiveness analysis.
A real-life cohort from Maasstad Hospital (2020–2021) in the Netherlands, with 772 patients with rheumatoid arthritis (RA), was used to assess the cost-effectiveness of electronic consultations (e-consultations) compared with face-to-face consultations. The Incremental Cost-Effectiveness Ratio (ICER), based on the generic EQ-5D, was compared with ICER’s based on RA-specific measures: the Rheumatoid Arthritis Impact of Disease (RAID) and Health Assessment Questionnaire-Disability Index (HAQ-DI). To compare the cost-effectiveness of these different measures, HAQ-DI and RAID were expressed in quality-adjusted life-years (QALYs) via estimated conversion equations.
Disease-specific patient-reported outcome measures (PROMs) offer a promising alternative for traditional measures in economic evaluations, capturing patient-relevant domains more comprehensively. Because PROMs are increasingly applied in clinical practice, the next step entails modeling of an RA patient-wide conversion equation to implement PROMs in economic evaluations.
The conventional ICER (eg, EQ-5D) indicates that e-consultations are cost-effective with cost savings of −€161,000 per QALY gained for a prevalent RA cohort treated in a secondary trainee hospital. RA-specific measures show similar results, with ICERs of −€163,000 per HAQ-DI (QALY) and −€223,000 per RAID (QALY) gained. RA-specific measures capture patient-relevant domains and offer the
Co-hosted by the Healthcare Transformation Academy
ECHORM’s first Journal Club of 2024 is co-hosted by the Healthcare Transformation Academy. This Journal Club is also the HTA Community of Practice’s first learning event of 2024.
According to their website, “the ongoing transformation in healthcare organisations require professionals to be equipped with new competencies and skills in innovation. EIT Health and organisations from the European University Hospital Alliance (EUHA) designed the Healthcare Transformation Academy to meet this challenge. The Academy offers high-quality and affordable on-demand courses in innovation management, high-value care, digital transformation, and leadership.” Find out more information here.