Value Assessment Tools Help Collect Data, Determine Spending

In an interview with Pharmacy Times at AMCP Nexus 2023, Kimberly Westrich, MA, director of Value & Access Strategy at Xcenda/Cencora, discussed value assessment tools and how they can help make key decisions in health care spending.

Q: What are value assessment tools and how can they contribute to enhancing health care outcomes in the US?

A: So, value assessment tools are something that really started to develop here in the United States in 2015. We were in a period and still are in a period where we're moving from volume-based purchasing, fee-for-service world to value-based purchasing. And the idea of value assessment frameworks is a structured way to collect information about health care, treatments, procedures, interventions, and determine what are the best choices to make with our limited health care dollars.

Q: What are the potential advantages and obstacles associated with seeking health technology assessments in the US, particularly for pharmacists?

A: So, one of the ways that they can help to make these decisions is we do have all of this information out there, and it can pull that information together in a more structured and organized way. So if you are someone who's working for a health plan and you're trying to make a decision about a treatment, and you have an organized inventory of all of the studies that have been done, and a sense of the quality of that evidence, and what are the important contextual considerations—it might be something like the impact on health equity or severity of disease—if you have all that information that's pulled together and organized in a structured way, that can be really helpful. The important thing is knowing that you can rely on the quality and comprehensiveness of that information. And I think it's great to have multiple sources of information, so you've got multiple tools that have pulled together similar information, but maybe are looking at it from a different lens. That can be particularly helpful.

Q: In what ways can these value assessment tools assist health care payers in making informed decisions regarding pharmaceutical interventions and formulary management?

A: I think one of the biggest obstacles for pharmacists to keep in mind is that many value assessment frameworks are really designed for population level decision making, so a health plan that's thinking about coverage and reimbursement across its entire population of beneficiaries. And pharmacists are involved in that front line patient care in many situations, and they're thinking about an individual patient. And so, if you're making a decision that's based on an individual patient, it's important to think about whether or not you're looking at a value assessment framework that was designed for individual patient decision making, or is it something that was designed for population level decision making? So, I think that's something that I always try to tell people to keep in mind is, what was the purpose of this particular value assessment framework? And does it match with the decision context that you're using it for?