Wurcel Victoria, Cicchetti Americo, Garrison Louis, Kip Michelle M A, Koffijberg Hendrik, Kolbe Anne, Leeflang Mariska M G, Merlin Tracy, Mestre-Ferrandiz Jorge, Oortwijn Wija, Oosterwijk Cor, Tunis Sean, Zamora Bernarda
HTA for diagnostics expert, former HTA Manager at MedTech Europe, Buenos Aires, Argentina,
Universita Cattolica del Sacro Cuore, Rome, Italy.
Public Health Genomics. 2019;22(1-2):8-15. doi: 10.1159/000501832. Epub 2019 Jul 22.
Health systems around the world seek to address patients' unmet health needs for a range of acute and chronic diseases. Simultaneously, governments strive to keep healthcare spending sustainable, while providing equal access to high-quality care. This has fuelled debate around what constitutes a valuable healthcare intervention in a health system and the corollary consideration of what governments are willing to pay for a certain health intervention. Until recently, the value of information in general, and the value of diagnostic information (VODI) specifically, was not part of the discussion.However, investment in diagnostic information can be a key development as information may guide more effective and efficient healthcare and help maintain an affordable health system. This paper therefore explores ways to best define, evaluate, and reward the value created from diagnostics in healthcare and how to include these value considerations in decision-making processes for diagnostics. The authors ultimately call for a holistic VODI framework that accounts for the full range of potential benefits of diagnostic testing, beyond the traditional clinical and health economic domains, and that is essential to recognise, measure, and fully leverage the benefits of diagnostics for patients, health systems, and society.
世界各地的卫生系统都在努力满足患者对一系列急慢性疾病未得到满足的健康需求。与此同时,各国政府努力保持医疗支出的可持续性,同时确保人们能够平等获得高质量的医疗服务。这引发了关于在卫生系统中什么构成有价值的医疗干预以及随之而来的政府愿意为某种医疗干预支付多少费用的讨论。直到最近,一般信息的价值,特别是诊断信息的价值(VODI),都没有成为讨论的一部分。然而,对诊断信息的投资可能是一个关键的发展方向,因为信息可以指导更有效和高效的医疗保健,并有助于维持一个负担得起的卫生系统。因此,本文探讨了如何最好地定义、评估和奖励医疗保健中诊断所创造的价值,以及如何将这些价值考量纳入诊断的决策过程。作者最终呼吁建立一个全面的VODI框架,该框架要考虑到诊断测试潜在益处的全部范围,超越传统的临床和卫生经济领域,并且对于认识、衡量和充分利用诊断对患者、卫生系统和社会的益处至关重要。