A recent debate in the Health Economics and Outcomes Research community identified option value as one of the elements warranting consideration in the assessment of medical technologies in contexts characterized by fast-paced innovation. A scoping review on contributions on option value in the healthcare sector was performed to identify the definition of option value, methods used to incorporate it in standard economic evaluations, and theoretical implications of its use. Findings show the coexistence of distinct conceptualizations of option value in the literature; to advocate for clarity of terminology, we propose a taxonomy distinguishing insurance value, real option value, and option value of survival. We claim the latter definition is the one relevant for the recent value frameworks and present findings from eight empirical applications of option value of survival estimation across seven therapeutic areas. Furthermore, we propose a general framework for its estimation applied to treatments for patients with newly-diagnosed multiple myeloma who are ineligible to autologous stem cells transplant in the perspective of the Italian healthcare system. We conclude that accounting for the option value of survival impacts the cost-effectiveness of treatments depending on disease progression and mortality rate. We argue that future research should focus on reaching consensus on the inclusion of option value of survival in economic evaluations and on developing and validating reliable methods for its ex-ante estimation.
Speakers Oriana Ciani, Carlo Federici, Giulia Fornaro, Carla Rognoni, CERGAS