Assessing the broader value of medicines: why does it matter and where do we go from here?

The ways in which we assess and pay for medicines and technologies reflect only the partial value that good health brings to healthcare systems and wider society. During a popular session at the recent World Evidence, Pricing and Access Congress 2025 in Amsterdam, Catrin Treharne (Health Economics Lead, LCP Health Analytics) and Jutta Skau (Product Creator, Novo Nordisk Transformational Prevention Unit) made the case for expanding the traditional definition of value in the assessment of healthcare interventions, proposing that the case for consideration of broader value is more compelling than ever and that only with engagement from industry will we see gradual normalization of the methods and approaches discussed.

What is meant by broader value?

Catrin Treharne opened the session by defining broader value, explaining that, while decision-makers have typically adopted a healthcare system perspective, considering costs to the healthcare system and benefits to patients, there is increasing discourse about casting the net wider to consider impacts on wider society and impacts to governments.

Treharne gave the example of the Second Panel on Cost Effectiveness in Health and Medicine who in 2016 recommended that every cost-effectiveness analysis use both the healthcare sector and societal perspectives. Further, she introduced the concept of the ISPOR Value Flower, proposed by an ISPOR special taskforce, and intended to reflect a much wider range of potential benefits of interventions. The value flower incorporates 'petals' representing three categories:

1. Core elements of value; namely, net costs and QALYs gained
2. Common but inconsistently used elements of value (productivity and family spillover)
3. Potential novel elements of value, including equity, insurance value, and scientific spillovers

Treharne explained that LCP Health Analytics is seeing growing interest from clients in both life sciences companies and third-sector organizations in quantifying value across many of the non-core and novel elements of value presented, and, specifically, to consider assessment of value to government. Treharne shared some persuasive statistics in support of this increased interest.

Why the increased interest in broader value?

Firstly, Treharne highlighted the challenge of economic inactivity faced by governments around the world, explaining that across the EU in 2021, 26.4% of people aged 15–64 were outside the work force, with rates as high as 35.5% in Italy. In the UK, long-term sickness has been rising and is now the most common reason given for being economically inactive. The number of people in the UK who are inactive because of long-term sickness increased to a record high of 7% of the working-age population in 2024. Treharne then highlighted the link between economic inactivity and welfare spending, sharing data from the EU which indicates that government expenditure on social protection was at 19.5% of GDP in the EU in 2022, with sickness and disability payments accounting for the second largest group of payments, second only to old age.

Moving to a case study for illustration, Treharne presented a recent report, in which LCP Health Analytics modelled the effects on social security costs in the UK when someone is enabled to stay in work in good health rather than moving onto long-term receipt of sickness-related benefits. Using obesity as an example, LCP estimated the net effects on welfare costs when an individual moves out of paid work because of ill health and found the potential cost savings to be significant. The research found that for every one person out of work and on sickness-related benefits rather than standard benefits for the unemployed, there is an additional annual cost of £9300. Over a median duration of 5 years on benefits, these are savings of £46,500 per person. To put this into context, the savings described here would be equivalent to the NHS resources needed for 6 knee replacements, 12 strokes, or 16 heart attacks – significant cost savings within the context of economic evaluation that wouldn’t typically be considered.

The HTA and methods landscape

At this point in the talk, Treharne pivoted to discussing the health technology assessment (HTA) and methods landscape, firstly asking where HTA bodies stand on the inclusion of broader elements in guidelines. Treharne shared findings from a 2023 review of HTA guidelines on societal and novel value elements by Breslau and colleagues, which found a time trend of increasing references to societal and novel value elements in more recent guidelines. Treharne shared findings from another recent study by Avşar and co-authors, which found that the societal perspective was now defined in 73% of the guidelines of well-established agencies and in 56% of those of newly developed agencies. However, Treharne also drew the audience’s attention to the findings relating to the individual value elements identified, showing that only four appear in over half of the HTA guidelines reviewed by Breslau and colleagues, with many mentioned in very few. Of note, there are infrequent recommendations for inclusion of societal and novel value elements in base case analysis, the analysis most likely to inform the decision made.

From the methods perspective, Treharne suggested that recent years have seen encouraging developments with an uptick in discussion and publication methods for quantification of broader value elements. Treharne highlighted the 2024 paper by Shafrin and colleagues: a methods publication that builds on the ISPOR Value Flower in proposing a generalized cost-effectiveness analysis (GCEA) framework consisting of 15 broader value elements as petals with conventional cost-effectiveness analysis at the core. The authors provide recommended approaches, with the framework designed so that analyses can be viewed on a spectrum ranging from conventional to fully GCEA, thereby providing guidelines for researchers to adopt.

Challenges

Before handing over to Jutta Skau for an industry view on the topic, Treharne recognized three key challenges that stand in the way of wide adoption of broader value elements in decision-making:

1. Incorporating broader value elements is complex and is limited by data challenges in terms of data availability and granularity.
2. There is a real risk that the limited consensus currently seen on the topic across HTA bodies could lead to inconsistencies and increased uncertainty in decision-making.
3. The reality of budget siloes and the fact that separate healthcare and social welfare budgets mean that decision-makers may not see the full financial impact. Treharne suggested that there is a clear case for stakeholders to work together to find practical solutions to this challenge.

An industry perspective

Jutta Skau, PhD, Product Creator, presented Novo Nordisk’s Transformational Prevention Unit (TPU), a pioneering scientific and business innovation unit established in 2023. The TPU’s mission is to develop science-based, scalable commercial solutions to prevent obesity and its consequences for people at risk. The TPU’s vision is to increase obesity-free life-years, so people live healthier and longer lives. Increasing obesity-free life-years is sought to be achieved by firstly reducing the number of new cases of obesity amongst people at predicted high risk of disease, and secondly prolonging the duration of time such people live without obesity. As such, we seek to predict who is at risk of developing obesity and prevent the disease from happening in the first place. The unit’s approach is to combine Novo Nordisk’s scientific insights with various types of data – including from clinics, public health, wearables – and to identify and target specific trigger points in people’s lives early in the disease trajectory, before the disease manifests. These trigger points can occur during significant life events such as moving away from home, becoming a parent, or retiring. This approach enables personalized interventions, tailored to people’s genetic predisposition, environment, social background and many other factors. The TPU is exploring solutions that can be taken to scale under four product categories: risk and response assessment models, engagement and monitoring tools, behavioral interventions and biological interventions.

Skau emphasized the need to build a rationale towards the payer segment for investing in primary prevention interventions. Skau welcomes and supports discussions on the importance of measuring the broader value of health interventions, to enable a more holistic and sustainable approach to perform cost-effectiveness analyses. When focusing on primary prevention, the goal is sustained good health, and therefore it is necessary to understand and measure the broader societal value rather than solely focusing on the individual impact.

Call to action

Both speakers agreed that consideration of broader value is more relevant than ever, and that methods are established and increasingly accepted, suggesting that increasing use will lead to gradual normalization. Treharne emphasized the need for industry to be targeted in their efforts, aligning around disease, stakeholders and value elements combinations of greatest relevance to maximise impact, stating:

“Wider adoption of broader value elements hinges on industry leadership. Only by generating robust data on societal impacts can we accelerate change in HTA decision-making.”

Authors

Catrin Treharne
Health Economics Lead, LCP Health Analytics

Catrin Treharne is a Principal and Health Economics Lead in LCP’s Health Analytics team, with more than 13 years’ experience in health economics and health technology assessment. Catrin’s experience spans the product lifecycle, from early economic models to global models suited for health technology assessment, as well as models developed for use in local payer negotiations. In her work, Catrin advances the application of methods to quantify health inequalities and reflect the broader value of health in decision-making.

Jutta Skau
Product Creator, Novo Nordisk Transformational Prevention Unit

Jutta Skau is a 'Product Creator' within the newly established Transformational Prevention Unit at Novo Nordisk. With extensive experience in health innovation, she has been at the forefront of leading innovative health projects aimed at identifying effective solutions for primary prevention of cardiometabolic diseases, both at the individual level and within the broader societal context. Jutta Skau firmly believes in the necessity of diverse skill sets and capabilities to challenge the status quo and foster innovative thinking in addressing solutions for primary prevention of cardiometabolic diseases. As part of her role, she actively facilitates workshops and projects that bring together a range of expertise, fostering an environment where unconventional thinking leads to impactful solutions.

Academically, Jutta Skau holds a master's degree in Public Health Science and a PhD in Child Nutrition, both earned from the University of Copenhagen.

Sponsorship for this Guest Column was provided by LCP Health Analytics.