Achieving Patient-Centered Value/Health Technology Assessment: Recommendations From a Multistakeholder eDelphi Panel.

Abstract

Objectives: Current methodological guidelines for value/health technology assessment (V/HTA) and cost-effectiveness analysis describe traditional approaches not originally created to be patient centered. The objective of this study was to identify opportunities for guidance and develop a set of consensus recommendations on methods and needs for patient-centered V/HTA, including identifying and collecting data inputs, results reporting, and future priority topics.

Methods: This study included multiple phases: (1) listening sessions with 10 patient group representatives to elicit priorities for patient-centered data elements for V/HTA; (2) leverage findings from step 1 to inform qualitative interviews with 10 health economists to guide the development of an eDelphi instrument; and (3) use the findings from step 1 and 2 to conduct an eDelphi exercise with multistakeholder participants to develop consensus recommendations that guide patient-centered V/HTA.

Results: After 2 Delphi rounds, 28 statements achieved consensus (≥80% agreement); 2 statements did not achieve consensus (<80% agreement). The recommendations included a need for data that more broadly reflect the impacts, both inside and outside the healthcare sector, relevant to patients and more accurately reflect the real-world natural history of disease. There was consensus on the need for patient input throughout the assessment process, including plain-language reporting that improves inclusion of patient audiences.

Conclusions: Multistakeholder consensus on the recommendations presented serve as a basis for future work toward progressing patient-centered V/HTA.