ISSUE:

Employers, particularly large employers self-sponsoring health insurance, are consequential decision-makers for healthcare coverage and access in the U.S. However, employers have a distinct perspective and objectives compared to publicly financed health insurance programs, private insurers who sell products to employers, and health technology assessment organizations. Given that the employer perspective is rarely explicitly addressed in research or health technology assessments, this panel will discuss whether common value frameworks such as the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Value Flower and the Institute for Clinical and Economic Review (ICER) Value Assessment Framework can sufficiently reflect the employer’s perspective and evidence needs.

OVERVIEW:

In recent years, there have been efforts to coalesce evidence generation to common value frameworks. Importantly, these frameworks have explicitly expanded value dimensions beyond quality-adjusted life years (QALYs) and direct healthcare costs. In the case of the ISPOR Value Flower, value dimensions include elements such as health equity, real option value, and scientific spillovers. In the case of the ICER Value Assessment Framework, short-term affordability, productivity, and caregiver burden are considered quantitatively, with other qualitative components of the deliberative process. However, whether these value frameworks do or do not successfully meet the needs of employers, who collectively make health benefit decisions for over half of the U.S. population, has not been sufficiently discussed. The panel will start with a 10-minute overview by the moderator, Dr. Lofgren, on the unique considerations of employers. The panel will then discuss how the ICER and ISPOR value frameworks do and do not address the employer perspective anchored on 1-2 case studies. In our discussion experts will speak from their specific perspectives as an institutional leader (Dr. Ollendorf), academic researcher (Dr. Doshi) and employer benefits strategist (Mr. Prettol). We will conclude with recommendations for creating evidence more inclusive of the employer perspective.