Dr Darius Lakdawalla Discusses the Meaning and Measure of "Value" in Healthcare

The perspective of the decision maker in healthcare affects the meaning of value and the US healthcare system is still trying to figure out how to measure value, said Darius Lakdawalla, PhD, Quintiles Chair in Pharmaceutical Development and Regulatory Innovation at the School of Pharmacy at the University of Southern California.

Transcript (slightly modified)

In what ways does the idea of “value” vary, and how can the healthcare industry bridge the gap?

Value depends on several factors that vary. One is just the perspective of the decision maker, so value to an employer, for instance, may be very different than value to an insurance company. The employer might worry about the number of sick days, how productive its employees are, how healthcare affects that productivity. The payer might be focused on things like the medical costs, the prescription drug costs, the direct health benefits, and may be less concerned about things that the patient cares about, like the burden on family members for care.

So, value is going to generally incorporate different aspects depending on the perspective of the decision maker involved.

The number of value frameworks is growing, but are they being used yet in meaningful ways?

I think that right now we are in a situation where we are trying to figure out how to measure value. I think there is a lot of controversy over how to measure value and we see that in all of the debates about what value frameworks to use and how to construct value frameworks. I think actually, that the bigger question here is: how do you bring value into the marketplace?

Even if we magically figured out tomorrow how to solve all of these measurement problems, it’s still not 100% clear what we would do next. Would we hand those numbers over to a new federal agency to regulate prices? Would we somehow use those numbers in the marketplace to help decision makers make price decisions that are more aligned with value? No one really knows and I think we need to begin to work on that problem if we are ultimately going to make an impact on value in healthcare more generally.