Value-of-Information Analysis within a Stakeholder-Driven Research Prioritization Process in a US Setting: An Application in Cancer Genomics

Abstract

Objective. The objective of this study was to evaluate the feasibility and outcomes of incorporating value-of-information (VOI) analysis into a stakeholder-driven research prioritization process in a US-based setting. Methods. Within a program to prioritize comparative effectiveness research areas in cancer genomics, over a period of 7 months, we developed decision-analytic models and calculated upper-bound VOI estimates for 3 previously selected genomic tests. Thirteen stakeholders representing patient advocates, payers, test developers, regulators, policy makers, and community-based oncologists ranked the tests before and after receiving VOI results. The stakeholders were surveyed about the usefulness and impact of the VOI findings. Results. The estimated upper-bound VOI ranged from $33 million to $2.8 billion for the 3 research areas. Seven stakeholders indicated the results modified their rankings, 9 stated VOI data were useful, and all indicated they would support its use in future prioritization processes. Some stakeholders indicated expected value of sampled information might be the preferred choice when evaluating specific study designs. Limitations. Our study was limited by the size and the potential for selection bias in the composition of the external stakeholder group, lack of a randomized design to assess effect of VOI data on rankings, and the use of expected value of perfect information v. expected value of sample information methods. Conclusions. Value of information analyses may have a meaningful role in research topic prioritization for comparative effectiveness research in the United States, particularly when large differences in VOI across topic areas are identified. Additional research is needed to facilitate the use of more complex value of information analyses in this setting.