Better Late Than Never? Payer Appetite and Vision for a National Value Assessment Body

Author(s)

Baker L1, Szydlowski N2, Westrich K3, Loo V1
1Cencora, Conshohocken, PA, USA, 2Cencora, Chicago, IL, USA, 3Cencora, Herndon, VA, USA

OBJECTIVES: The United States (US) has a decentralized healthcare system with a mix of public and private entities assessing the value of healthcare interventions for coverage and reimbursement decisions. Some healthcare stakeholders and experts have proposed the creation of a US national value assessment body. Our objective is to understand payer perspectives on a national value assessment body and its ideal role(s) in value assessment.

METHODS: A double-blinded web-based survey of US healthcare payers was fielded through Cencora’s research panel, the Managed Care Network, in July 2023.

RESULTS: A total of 48 managed care advisors (56% health plans, 25% pharmacy benefit managers, 19% integrated delivery networks), composed primarily of pharmacy directors (58%) and medical directors (35%), completed the survey. 71% of payers thought the US should create a national value assessment body, whereas 15% said it should not, and 15% were unsure. Most payers preferred a single body (65%) over multiple bodies (10%), with 25% indicating no preference. The preferred funding source was government funding only (46%) followed by a mix of private and government funding (42%) and private funding only (6%). In a multiple-response question, payers said the ideal purpose for a national body would be to develop value assessment standards in the US (85%), evaluate the quality of value assessments conducted by third-party organizations (69%), and conduct value assessments (63%).

CONCLUSIONS: Nearly three-quarters of payers in this survey agreed that the US should create a national assessment body. Payers were split on government-only funding vs a mix of government and private funding. Respondents were most interested in a national body focused on developing value assessment standards, although there was support for evaluating the quality of value assessments conducted by others and conducting value assessments.

Conference/Value in Health Info

2024-05, ISPOR 2024, Atlanta, GA, USA

Value in Health, Volume 27, Issue 6, S1 (June 2024)

Code

HTA74

Topic

Health Technology Assessment, Study Approaches

Topic Subcategory

Surveys & Expert Panels, Systems & Structure

Disease

No Additional Disease & Conditions/Specialized Treatment Areas

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