Health Technology Assessment (HTA) can adopt different ‘perspectives’ on the appropriate scope of a value appraisal, from a relatively narrow ‘payer’ perspective, considering direct impacts on patients and the healthcare system, to a much broader ‘societal’ perspective that can include direct and indirect impacts on patients, their carers and families, employers, government departments, and society as a whole. Different HTA bodies adopt different perspectives, with some bodies taking a much broader perspective – and accounting for more aspects of value – than others.

This session will demonstrate the importance of recognising value drivers beyond health-related quality-of-life and direct medical costs for diseases with substantial 'spillover effects', using breast cancer as a case study. The efficacy of current breast cancer treatments in terms of survival means that payers see relatively low unmet needs around the treatment of breast cancer. However, there are important value elements in breast cancer that receive limited recognition under a narrow 'payer perspective' on value. A broader perspective would better account for the full value of more efficacious and more tolerable treatments. These broader value elements can relate to spillovers around family effects, informal caregiving, productivity, and fiscal impacts on society. Recognition of this value would appropriately incentivise innovation that can produce benefits across society.

Sponsor: Office of Health Economics