4.6 Review

Broadening the Concept of Value: A Scoping Review on the Option Value of Medical Technologies

Journal

VALUE IN HEALTH
Volume 24, Issue 7, Pages 1045-1058

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jval.2020.12.018

Keywords

HTA; innovation in healthcare; option value; value of healthcare

Funding

  1. JanssenCilag Italy

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This study conducted a scoping review on the option value of healthcare technologies, identifying different definitions and relevant conceptual aspects, as well as proposing methods for its incorporation in economic evaluations. The review found that estimates of the total value of technologies, including option value, varied widely in empirical studies, ranging from +7% to +469% of their conventional value. Future work should focus on developing and validating reliable methods for estimating option value in economic evaluations.
Objectives: A recent debate in health economics and outcomes research community identified option value as one of the elements warranting consideration in the assessment of medical technologies. To conduct a scoping review of contributions on option value in the healthcare sector and identify relevant conceptual aspects and methods used to incorporate it in standard economic evaluations. Methods: A systematic search was conducted up to July 2020 to identify contributions from electronic bibliographic database and gray literature. Data on the proposed definitions of option value, theoretical implications of its use in economic evaluations, and methods used to estimate it were extracted and analyzed. Results: We found 57 eligible studies. Three different definitions emerged: insurance value, real option value, and option value of survival. Focusing on the latter (24 studies), we analyzed in depth 8 empirical applications across 7 therapeutic areas. The most relevant methodological challenges were on the perspective used in economic evaluations and how to robustly manage forecasting uncertainty, update cost-effectiveness thresholds, and avoid double-counting issues. For empirical studies assessing the total value of the technology, including option value, estimates ranged from +7% to +469% of its conventional value. Conclusions: This review synthesizes theoretical and empirical aspects on option value of healthcare technologies and proposes a terminology to distinguish 3 different concepts identified. Future work should focus primarily on agreeing on whether option value should be included in economic evaluations and, if so, on developing and validating reliable methods for its ex-ante estimation.

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