Use Health Technology Assessment to Add More “Value” to Value Analysis
There are many definitions for value analysis, but I think we could all agree that value analysis in healthcare today is a creative analytical study and evaluation of the function of a product, service, or technology. The objective of any value analysis exercise is to determine the lowest cost approach that will provide an equivalent or better performance or outcome.
With the pressures affecting healthcare today, it’s time to add more value to the process. To do so, we need to bridge the evidence gap and start using a systematic and objective evidence-based approach, a process we call evidence-based value analysis (EBVA).
I’ve talked in previous columns about how using EBVA to assess and compare the clinical value, as well as the operational and financial impact, of new and existing health technologies takes traditional value analysis to the next level. A good starting point to better understand the scientific and clinical evidence of a product’s value is health technology assessment (HTA).
HTA is the systematic and objective evaluation of the technical performance, safety, clinical efficacy, effectiveness, cost, cost-effectiveness, organizational implications, social consequences, and legal and ethical considerations of the application of a health technology, in most cases a drug, medical device, or clinical or surgical procedure. Many experts describe HTA as a bridge between evidence and policy-making since HTA provides stakeholders with accessible, evidence-based information they can use to make decisions about which health technologies to adopt, which to eliminate, and how to efficiently allocate scarce healthcare resources. More importantly, HTA enables hospitals to identify and stop using interventions that are unsafe or ineffective or that have an unfavorable benefit/risk ratio.
So where would HTA fit into your current value analysis process? You can incorporate HTA anywhere in the course of evaluating the products, devices, services, and interventions we use to deliver care to patients, but I would suggest that HTA become the foundation upon which you build your EBVA process. “Does good evidence exist?” is the first question you need to answer before you can proceed with decision making. HTA could help VA teams to determine whether they should proceed at all. Often the lack of evidence is as much a determining factor as the presence of good evidence. Once the HTA is completed, the team can proceed with financial and internal business analyses.
Why should we link HTA and value analysis?
1. To improve patient safety and clinical outcomes: A systematic review of the research may pick up warning signs and identify those technologies that will need closer monitoring.
2. To promote efficient utilization of resources: The United States has the most expensive healthcare in the world, but our outcomes are not commensurate with our spending. Studies have shown that in certain regions of the United States, there is no correlation between the dollars spent on healthcare and health outcomes. We need to achieve better clinical outcomes for the money we spend.
3. To support strategic technology planning and reduce conflict: With the numerous requests for new and expensive technologies, many of which are made based on clinician preference, the use of evidence to determine cost-effectiveness is essential. Let evidence become the neutral ground you use to make decisions, set priorities, diffuse conflict, and provide justification for strategic planning decisions.
4. To guide the appropriate implementation of health technologies: A systematic approach can identify up-front issues such as training and credentialing, compatibility, patient flow, and turf battles and ensure smoother adoption of new technology.
5. To maximize cost-effectiveness and achieve sustainable goals and financial viability for the organization.
HTA can be the bridge that enables you to add greater value to value analysis in your organization. This will allow you to acquire health technologies that yield high-quality care at a sustainable cost and avoid or eliminate ineffective or unsafe technologies. It is possible to improve patient care while achieving greater financial viability.