Health Technology Assessment and Value Assessment Frameworks to Inform Coverage Reimbursement

Health technology assessment (HTA) and value assessment frameworks can serve as resources for determining the value of pharmaceuticals and other health interventions. To improve value assessments and their application to formulary decision making, AMCP convened key stakeholders in managed care and focused on three main objectives:

1. Outline considerations for how value should be recognized in a system of constrained resources.
2. Explore the evolution of value frameworks to guide coverage and reimbursement decisions.
3. Identify education and managed care tools to aid the application of value assessment findings.

A key theme was that increasing value through innovative novel pharmaceutical product coupled with more complete data results should be recognized. However, defining value may vary based on perspective. While utilizing value assessments is one part of determining coverage and reimbursement, coverage decision makers advocated that more value assessments are needed from trusted resources. Participants also identified best practices to continue improvement of current value assessment tools and processes. Several areas noted for improvement include more robust data collection, analytical systems, and increased education on value assessment tools and frameworks across the health care industry.

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