Advertisement

What Is Value in Health and Healthcare? A Systematic Literature Review of Value Assessment Frameworks

  • Mengmeng Zhang
    Affiliations
    Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
    Search for articles by this author
  • Yun Bao
    Affiliations
    Institute of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou, China
    Search for articles by this author
  • Yitian Lang
    Affiliations
    Department of Pharmacy, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Shihui Fu
    Affiliations
    School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
    Search for articles by this author
  • Melissa Kimber
    Affiliations
    Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
    Search for articles by this author
  • Mitchell Levine
    Affiliations
    Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University, Hamilton, ON, Canada
    Search for articles by this author
  • Feng Xie
    Correspondence
    Correspondence: Feng Xie, PhD, Department of Health Research Methods, Evidence, and Impact, Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St West, Hamilton, ON, Canada L8S 4L8.
    Affiliations
    Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

    Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
    Search for articles by this author
Published:September 17, 2021DOI:https://doi.org/10.1016/j.jval.2021.07.005

      Highlights

      • The goal of value assessment is to promote an efficient and equitable healthcare system. Nevertheless, there is no global consensus on how to define and measure value in healthcare.
      • A total of 57 value assessment frameworks (VAFs) were included in this review. The attributes of value can be broadly grouped into 9 categories: health benefits, affordability, societal impact, burden of disease, quality of evidence, cost-effectiveness, ethics and equity, unmet needs, and innovation. Literature review has been the primary method to define value, whereas weighting is commonly used to derive value scores.
      • There are substantial variations in defining and measuring value. A noticeable weakness of existing VAFs is that patient/public engagement was generally limited or missing in the framework development process. Existing VAFs tend to aggregate multiple value attributes into a single index for decision making.

      Abstract

      Objectives

      This study aimed to investigate how value is defined and measured in existing value assessment frameworks (VAFs) in healthcare.

      Methods

      We searched PubMed, Embase, the Cochrane Library, and Centre for Reviews and Dissemination from 2008 to 2019. We also performed backward citation chaining of included studies and previously published systematic reviews. Studies reporting the development of a VAF in healthcare were included. For each included framework, we extracted and compared the context, target users, intended use, methods used to identify value attributes, description of the attributes, and attribute scoring approaches.

      Results

      Of the 8151 articles screened, 57 VAFs were included. The value attributes included in 55 VAFs were grouped into 9 categories: health benefits (n = 53, 96%), affordability (n = 45, 82%), societal impact (n = 42, 76%), burden of disease (n = 36, 65%), quality of evidence (n = 32, 58%), cost-effectiveness (n = 31, 56%), ethics and equity (n = 27, 49%), unmet needs (n = 21, 38%), and innovation (n = 15, 27%). The remaining 2 VAFs used broad attributes or user-defined attributes. Literature review was the main approach to identify value attributes in 36 VAFs. Patient or public was engaged through the development of only 11 VAFs. Weighting has been used to score 29 VAFs, of which 19 used the methods of multicriteria decision analysis.

      Conclusions

      There are substantial variations in defining and measuring value. A noticeable weakness of existing VAFs is that patient or public engagement was generally very limited or missing in framework development process. Existing VAFs tend to aggregate multiple value attributes into a single index for decision making.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Value in Health
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • World Health Organization
        Public spending on health: a closer look at global trends. WHO.
        • Dixon-Fyle S.
        • Kowallik T.
        Engaging consumers to manage health care demand.
        • Centers for Medicare and Medicaid Services
        What are value-based programs?.
        • National Library of Medicine
        HTA 101: II. Fundamental concepts.
        • Health Technology Assessment International
        About HTAi.
        https://htai.org/about-htai/
        Date accessed: November 19, 2020
        • Evidence-Based Medicine Working Group
        Evidence-based medicine. A new approach to teaching the practice of medicine.
        JAMA. 1992; 268: 2420-2425
        • Dobrow M.J.
        • Goel V.
        • Upshur R.E.G.
        Evidence-based health policy: context and utilisation.
        Soc Sci Med. 2004; 58: 207-217
        • Hoffmann C.
        • Graf von der Schulenburg J.M.
        The influence of economic evaluation studies on decision making. A European survey. The EUROMET group.
        Health Policy. 2000; 52: 179-192
        • Trueman P.
        • Drummond M.
        • Hutton J.
        Developing guidance for budget impact analysis.
        Pharmacoeconomics. 2001; 19: 609-621
        • Neumann P.J.
        • Willke R.J.
        • Garrison Jr., L.P.
        A health economics approach to US value assessment frameworks-introduction: an ISPOR Special Task Force Report [1].
        Value Health. 2018; 21: 119-123
        • Institute for Clinical and Economic Review
        Methods update: value assessment framework.
        • Schnipper L.E.
        • Davidson N.E.
        • Wollins D.S.
        • et al.
        Updating the American Society of Clinical Oncology Value Framework: revisions and reflections in response to comments received.
        J Clin Oncol. 2016; 34: 2925-2934
        • Memorial Sloan Kettering Cancer Center, Drug Pricing Lab
        Drug Abacus.
        https://drugpricinglab.org/tools/drug-abacus/
        Date accessed: February 11, 2020
        • National Comprehensive Cancer Network
        NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) with NCCN Evidence Blocks.
        https://www.nccn.org/evidenceblocks/
        Date accessed: February 11, 2020
        • Cherny N.I.
        • Dafni U.
        • Bogaerts J.
        • et al.
        ESMO-Magnitude of Clinical Benefit Scale version 1.1.
        Ann Oncol. 2017; 28: 2340-2366
        • Neumann P.J.
        • Sanders G.D.
        • Russell L.B.
        • Siegel J.E.
        • Ganiats T.G.
        Cost-Effectiveness in Health and Medicine.
        Oxford University Press, New York, NY2016
        • Drummond M.
        • Sculpher M.J.
        • Claxton K.
        • Stoddart G.L.
        • Torrance G.W.
        Methods for the Economic Evaluation of Health Care Programmes.
        4th ed. Oxford University Press, New York, NY2015
        • Boztepe S.
        User value: competing theories and models.
        Int J Des. 2007; 1: 55-63
        • Institute of Medicine (US) Roundtable on Value & Science-Driven Health Care
        Value in Health Care: Accounting for Cost, Quality, Safety, Outcomes, and Innovation.
        National Academies Press (US), Washington, DC2010
        • Seixas B.V.
        • Dionne F.
        • Conte T.
        • Mitton C.
        Assessing value in health care: using an interpretive classification system to understand existing practices based on a systematic review.
        BMC Health Serv Res. 2019; 19: 560
        • González-Lorenzo M.
        • Piatti A.
        • Coppola L.
        • et al.
        Conceptual frameworks and key dimensions to support coverage decisions for vaccines.
        Vaccine. 2015; 33: 1206-1217
        • Willke R.J.
        • Neumann P.J.
        • Garrison Jr., L.P.
        • Ramsey S.D.
        Review of recent US value frameworks-a health economics approach: an ISPOR Special Task Force Report [6].
        Value Health. 2018; 21: 155-160
        • Morgan R.L.
        • Kelley L.
        • Guyatt G.H.
        • Johnson A.
        • Lavis J.N.
        Decision-making frameworks and considerations for informing coverage decisions for healthcare interventions: a critical interpretive synthesis.
        J Clin Epidemiol. 2018; 94: 143-150
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        • PRISMA Group
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Ann Intern Med. 2009; 151 (264-269, W64)
        • Dubois R.W.
        • Westrich K.
        As value assessment frameworks evolve, are they finally ready for prime time?.
        Value Health. 2019; 22: 977-980
        • Berry F.
        • Choi C.
        University of Sydney Library: Citation Chaining: How to Find More Information From One Source.
        • Institute for Clinical and Economic Review
        Institute for Clinical and Economic Review Releases Final Value Assessment Framework for 2017-2019.
        • Marsh K.
        • IJzerman M.
        • Thokala P.
        • et al.
        Multiple criteria decision analysis for health care decision making -- emerging good practices: report 2 of the ISPOR MCDA Emerging Good Practices Task Force.
        Value Health. 2016; 19: 125-137
        • Lakdawalla D.N.
        • Phelps C.E.
        Health technology assessment with risk aversion in health.
        J Health Econ. 2020; 72102346
        • Mitchell K.
        • Seidman J.
        Avalere and FasterCures release patient-perspective value framework to incorporate patient preferences into healthcare treatment decisions.
        • Alonso-Coello P.
        • Schünemann H.J.
        • Moberg J.
        • et al.
        GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: introduction.
        BMJ. 2016; 353: i2016
        • Anderson P.
        • Webb P.
        • Groves S.
        Prioritisation of specialist health care services; not NICE, not easy but it can be done.
        Health Policy. 2017; 121: 978-985
        • Angelis A.
        • Kanavos P.
        Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: the Advance Value Framework.
        Soc Sci Med. 2017; 188: 137-156
        • Badia X.
        • Aguarón A.
        • Fernández A.
        • et al.
        Patient involvement in reflective multicriteria decision analysis to assist decision making in oncology.
        Int J Technol Assess Health Care. 2019; 35: 56-63
        • Browman G.P.
        • Manns B.
        • Hagen N.
        • Chambers C.R.
        • Simon A.
        • Sinclair S.
        6-STEPPPs: a modular tool to facilitate clinician participation in fair decisions for funding new cancer drugs.
        J Oncol Pract. 2008; 4: 2-7
        • Choi S.E.
        • Berkowitz S.A.
        • Yudkin J.S.
        • Naci H.
        • Basu S.
        Personalizing second-line type 2 diabetes treatment selection: combining network meta-analysis, individualized risk, and patient preferences for unified decision support.
        Med Decis Mak. 2019; 39: 239-252
        • Dankó D.
        • Molnár M.P.
        Balanced assessment systems revisited.
        J Mark Access Health Policy. 2017; 51355190
        • Diaby V.
        • Lachaine J.
        An application of a proposed framework for formulary listing in low-income countries: the case of Côte d’Ivoire.
        Appl Health Econ Health Policy. 2011; 9: 389-402
        • Doyle J.J.
        • Hawryluk E.
        • Niemira J.
        • Wood B.
        Evidence-based valuation in oncology: lessons learned from a case study.
        Ther Innov Regul Sci. 2019; 53: 403-411
        • Dunlop W.C.N.
        • Mullins C.D.
        • Pirk O.
        • et al.
        BEACON: a summary framework to overcome potential reimbursement hurdles.
        Pharmacoeconomics. 2016; 34: 1051-1065
        • Finkelstein E.A.
        • Krishnan A.
        • Doble B.
        Beyond cost-effectiveness: a five-step framework for appraising the value of health technologies in Asia-Pacific.
        Int J Health Plann Manage. 2020; 35: 397-408
        • Gibson J.
        • Mitton C.
        • DuBois-Wing G.
        Priority setting in Ontario’s LHINs: ethics and economics in action.
        Healthc Q. 2011; 14: 35-43
        • Golan O.
        • Hansen P.
        Which health technologies should be funded? A prioritization framework based explicitly on value for money.
        Isr J Health Policy Res. 2012; 1: 44
        • Guarga L.
        • Badia X.
        • Obach M.
        • et al.
        Implementing reflective multicriteria decision analysis (MCDA) to assess orphan drugs value in the Catalan Health Service (CatSalut).
        Orphanet J Rare Dis. 2019; 14: 157
        • Inotai A.
        • Brixner D.
        • Maniadakis N.
        • et al.
        Development of multi-criteria decision analysis (MCDA) framework for off-patent pharmaceuticals - an application on improving tender decision making in Indonesia.
        BMC Health Serv Res. 2018; 18: 1003
        • Iskrov G.
        • Miteva-Katrandzhieva T.
        • Stefanov R.
        Multi-criteria decision analysis for assessment and appraisal of orphan drugs.
        Front Public Health. 2016; 4: 214
        • Jehu-Appiah C.
        • Baltussen R.
        • Acquah C.
        • et al.
        Balancing equity and efficiency in health priorities in Ghana: the use of multicriteria decision analysis.
        Value Health. 2008; 11: 1081-1087
        • Keech J.
        • Beca J.
        • Eisen A.
        • et al.
        Impact of a novel prioritization framework on clinician-led oncology drug submissions.
        Curr Oncol. 2019; 26: e155-e161
        • Krahn M.
        • Miller F.
        • Bayoumi A.
        • et al.
        Development of the Ontario decision framework: a values based framework for health technology assessment.
        Int J Technol Assess Health Care. 2018; 34: 290-299
        • Lee D.W.
        • Neumann P.J.
        • Rizzo J.A.
        Understanding the medical and nonmedical value of diagnostic testing.
        Value Health. 2010; 13: 310-314
        • Maciosek M.V.
        • Coffield A.B.
        • Edwards N.M.
        • Flottemesch T.J.
        • Solberg L.I.
        Prioritizing clinical preventive services: a review and framework with implications for community preventive services.
        Annu Rev Public Health. 2009; 30: 341-355
        • Marsh K.
        • Dolan P.
        • Kempster J.
        • Lugon M.
        Prioritizing investments in public health: a multi-criteria decision analysis.
        J Public Health (Oxf). 2013; 35: 460-466
        • Miller G.
        • Roehrig C.
        • Russo P.
        A framework for assessing the value of investments in nonclinical prevention.
        Prev Chronic Dis. 2015; 12: E216
        • Patel M.S.
        • Davis M.M.
        • Lypson M.L.
        The VALUE Framework: training residents to provide value-based care for their patients.
        J Gen Intern Med. 2012; 27: 1210-1214
        • Paulden M.
        • Stafinski T.
        • Menon D.
        • McCabe C.
        Value-based reimbursement decisions for orphan drugs: a scoping review and decision framework.
        Pharmacoeconomics. 2015; 33: 255-269
        • Pichon-Riviere A.
        • Garcia-Marti S.
        • Oortwijn W.
        • Augustovski F.
        • Sampietro-Colom L.
        Defining the value of health technologies in Latin America: developments in value frameworks to inform the allocation of healthcare resources.
        Int J Technol Assess Health Care. 2019; 35: 64-68
        • Piso B.
        • Wild C.
        Decision support in vaccination policies.
        Vaccine. 2009; 27: 5923-5928
        • Stafinski T.
        • Menon D.
        • McCabe C.
        • Philippon D.J.
        To fund or not to fund: development of a decision-making framework for the coverage of new health technologies.
        Pharmacoeconomics. 2011; 29: 771-780
        • Youngkong S.
        • Baltussen R.
        • Tantivess S.
        • Mohara A.
        • Teerawattananon Y.
        Multicriteria decision analysis for including health interventions in the universal health coverage benefit package in Thailand.
        Value Health. 2012; 15: 961-970
        • Anonychuk A.
        • Beastall G.
        • Shorter S.
        • Kloss-Wolf R.
        • Neumann P.
        A framework for assessing the value of laboratory diagnostics.
        Healthc Manag Forum. 2012; 25: S4-S11
        • Broqvist M.
        • Branting Elgstrand M.
        • Carlsson P.
        • Eklund K.
        • Jakobsson A.
        National Model for Transparent Prioritisation in Swedish Health Care: Reviderad version.
      1. CADTH. The pCODR Expert Review Committee (pERC). https://www.cadth.ca/collaboration-and-outreach/advisory-bodies/pcodr-expert-review-committee-perc. Accessed February 11, 2020.

        • Goetghebeur M.M.
        • Cellier M.S.
        Can reflective multicriteria be the new paradigm for healthcare decision-making? The EVIDEM journey.
        Cost Eff Resour Alloc. 2018; 16: 54
        • Garrison L.
        • Mestre-Ferrandiz J.
        • Zamora B.
        The value of knowing and knowing the value: improving the health technology assessment of complementary diagnostics.
        • Houweling H.
        • Verweij M.
        • Ruitenberg E.J.
        National Immunisation Programme Review Committee of the Health Council of the Netherlands. Criteria for inclusion of vaccinations in public programmes.
        Vaccine. 2010; 28: 2924-2931
        • Committee on Valuing Community-Based, Non-Clinical Prevention Programs; Board on Population Health and Public Health Practice; Institute of Medicine
        An Integrated Framework for Assessing the Value of Community-Based Prevention.
        National Academies Press, Washington, DC2012
        • Committee on Identifying and Prioritizing New Preventive Vaccines for Development, Phase III
        • Board on Population Health and Public Health Practice
        • Board on Global Health
        • Institute of Medicine
        • National Academy of Engineering
        Ranking Vaccines: Applications of a Prioritization Software Tool: Phase III: Use Case Studies and Data Framework.
        National Academies Press (US), Washington, DC2015
        • Kroese M.
        • Burton H.
        • Whittaker J.
        • Lakshman R.
        • Alberg C.
        A framework for the prioritization of investment in the provision of genetic tests.
        Public Health Genomics. 2010; 13: 538-543
        • NHS England chemotherapy clinical reference group for NHS
        Standard Operating Procedures: the Cancer Drugs Fund (CDF) Guidance to support operation of the CDF in 2015-16.
        https://www.england.nhs.uk/cancer/cdf/
        Date accessed: February 11, 2020
        • Oregon Health Services Commission
        Prioritization of Health Services: A Report to the Governor and the 75th Oregon Legislative Assembly.
        (Accessed June 29, 2020)
        • Pooripussarakul S.
        • Riewpaiboon A.
        • Bishai D.
        • Muangchana C.
        • Tantivess S.
        What criteria do decision makers in Thailand use to set priorities for vaccine introduction?.
        BMC Public Health. 2016; 16: 684
        • Porter M.E.
        What is value in health care?.
        N Engl J Med. 2010; 363: 2477-2481
        • Radaelli G.
        • Lettieri E.
        • Masella C.
        • Merlino L.
        • Strada A.
        • Tringali M.
        Implementation of EUnetHTA core Model® in Lombardia: the VTS framework.
        Int J Technol Assess Health Care. 2014; 30: 105-112
        • Seigfried R.J.
        • Corbo T.
        • Saltzberg M.T.
        • Reitz J.
        • Bennett D.A.
        Deciding which drugs get onto the formulary: a value-based approach.
        Value Health. 2013; 16: 901-906
        • Venhorst K.
        • Zelle S.G.
        • Tromp N.
        • Lauer J.A.
        Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers.
        Cost Eff Resour Alloc. 2014; 12: 13
        • Winquist E.
        • Bell C.M.
        • Clarke J.T.R.
        • et al.
        An evaluation framework for funding drugs for rare diseases.
        Value Health. 2012; 15: 982-986
        • Asaria M.
        • Griffin S.
        • Cookson R.
        Distributional cost-effectiveness analysis: a tutorial.
        Med Decis Making. 2016; 36: 8-19
        • Verguet S.
        • Kim J.J.
        • Jamison D.T.
        Extended cost-effectiveness analysis for health policy assessment: a tutorial.
        Pharmacoeconomics. 2016; 34: 913-923
        • Garrison Jr., L.P.
        • Neumann P.J.
        • Willke R.J.
        • et al.
        A health economics approach to US value assessment frameworks-summary and recommendations of the ISPOR Special Task Force Report [7].
        Value Health. 2018; 21: 161-165
        • Phelps C.E.
        • Lakdawalla D.N.
        • Basu A.
        • Drummond M.F.
        • Towse A.
        • Danzon P.M.
        Approaches to aggregation and decision making-a health economics approach: an ISPOR Special Task Force Report [5].
        Value Health. 2018; 21: 146-154
        • Goetghebeur M.M.
        • Wagner M.
        • Khoury H.
        • Levitt R.J.
        • Erickson L.J.
        • Rindress D.
        Evidence and Value: Impact on DEcisionMaking–the EVIDEM framework and potential applications.
        BMC Health Serv Res. 2008; 8: 270
        • Treweek S.
        • Oxman A.D.
        • Alderson P.
        • et al.
        Developing and evaluating communication strategies to support informed decisions and practice based on evidence (DECIDE): protocol and preliminary results.
        Implement Sci. 2013; 8: 6
        • Iskrov G.
        • Stefanov R.
        Criteria for drug reimbursement decision-making: an emerging public health challenge in Bulgaria.
        Balk Med J. 2016; 33: 27-35
        • Committee on Identifying and Prioritizing New Preventive Vaccines for Development, Board on Population Health and Public Health Practice, Board on Global Health, Institute of Medicine
        Ranking Vaccines: A Prioritization Framework: Phase I: Demonstration of Concept and a Software Blueprint.
        National Academies Press (US), Washington, DC2012
        • Golan O.
        • Hansen P.
        • Kaplan G.
        • Tal O.
        Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights?.
        Health Policy. 2011; 102: 126-135
        • Thokala P.
        • Devlin N.
        • Marsh K.
        • et al.
        Multiple criteria decision analysis for health care decision making--an introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force.
        Value Health. 2016; 19: 1-13
        • Innovation and Value Initiative
        Partnering with patients.
        • Coyle D.
        • Durand-Zaleski I.
        • Farrington J.
        • et al.
        HTA methodology and value frameworks for evaluation and policy making for cell and gene therapies.
        Eur J Health Econ. 2020; 21: 1421-1437
        • Vahdat S.
        • Hamzehgardeshi L.
        • Hessam S.
        • Hamzehgardeshi Z.
        Patient involvement in health care decision making: a review.
        Iran Red Crescent Med J. 2014; 16e12454
        • Mccarron T.
        • Moffat K.
        • Wilkinson G.
        • et al.
        Understanding patient engagement in health system decision-making: a co-designed scoping review.
        Syst Rev. 2019; 8: 97
        • Perfetto E.M.
        • Oehrlein E.M.
        • Boutin M.
        • Reid S.
        • Gascho E.
        Value to whom? The patient voice in the value discussion.
        Value Health. 2017; 20: 286-291
        • Guindo L.A.
        • Wagner M.
        • Baltussen R.
        • et al.
        From efficacy to equity: literature review of decision criteria for resource allocation and healthcare decision making.
        Cost Eff Resour Alloc. 2012; 10: 9
        • Reed S.D.
        • Dubois R.W.
        • Johnson F.R.
        • Caro J.J.
        • Phelps C.E.
        Novel approaches to value assessment beyond the cost-effectiveness framework.
        Value Health. 2019; 22: S18-S23
        • Lakdawalla D.N.
        • Doshi J.A.
        • Garrison Jr., L.P.
        • Phelps C.E.
        • Basu A.
        • Danzon P.M.
        Defining elements of value in health care-a health economics approach: an ISPOR Special Task Force Report [3].
        Value Health. 2018; 21: 131-139
        • Dankó D.
        Health technology assessment in middle-income countries: recommendations for a balanced assessment system.
        J Mark Access Health Policy. 2014; 2
        • Neumann P.J.
        Yes, improve the US value frameworks, but recognize they are already in prime time.
        Value Health. 2019; 22: 975-976
        • Coast J.
        • Smith R.D.
        • Lorgelly P.
        Welfarism, extra-welfarism and capability: the spread of ideas in health economics.
        Soc Sci Med. 2008; 67: 1190-1198
        • Brouwer W.B.F.
        • Culyer A.J.
        • van Exel N.J.A.
        • Rutten F.F.H.
        Welfarism vs. extra-welfarism.
        J Health Econ. 2008; 27: 325-338
        • Booth N.
        On value frameworks and opportunity costs in health technology assessment.
        Int J Technol Assess Health Care. 2019; 35: 367-372
        • Birch S.
        • Donaldson C.
        Valuing the benefits and costs of health care programmes: where’s the ‘extra’ in extra-welfarism?.
        Soc Sci Med. 2003; 56: 1121-1133
        • McCabe C.
        • Claxton K.
        • Culyer A.J.
        The NICE cost-effectiveness threshold: what it is and what that means.
        Pharmacoeconomics. 2008; 26: 733-744
        • McQueen R.B.
        • Slejko J.F.
        Toward modified impact inventory tables to facilitate patient-centered value assessment.
        Pharmacoeconomics. 2021; 39: 379-382
        • Roldán Ú.B.
        • Badia X.
        • Marcos-Rodríguez J.A.
        • et al.
        Multi-criteria decision analysis as a decision-support tool for drug evaluation: a pilot study in a pharmacy and therapeutics committee setting.
        Int J Technol Assess Health Care. 2018; 34: 519-526
        • Angelis A.
        • Kanavos P.
        • Phillips L.D.
        ICER Value Framework 2020 update: recommendations on the aggregation of benefits and contextual considerations.
        Value Health. 2020; 23: 1040-1048