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Volume 9
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10.1080/20016689.2021.1981574
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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Article

Bright Line or Lottery? On Significance and Value in Medical Decision Making

by
Jörg Mahlich
1,* and
Srirangan Dheban
2
1
Miltenyi Biomedicine, Bergisch Gladbach, Germany & Dice - University of Düsseldorf, Düsseldorf, Germany
2
Srirangan Dheban, Zurich, Switzerland
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2021, 9(1), 1981574; https://doi.org/10.1080/20016689.2021.1981574
Submission received: 11 June 2021 / Revised: 6 September 2021 / Accepted: 13 September 2021 / Published: 20 September 2021

Abstract

It is widely acknowledged that using p-value thresholds as the basis for making decision on health care spending is not appropriate. In the context of medical decision making, we argue that patient preferences need to be a stronger factor. Depending on attitudes to risk, patients might prefer a medical treatment that performs on average worse than a comparator but offers a small probability of a large gain such as a cure. However, what has been labeled ‘value of hope’ is not yet fully reflected in the decision-making process of drug approval and health technology assessment (HTA). Therefore, patient risk preferences should be formally incorporated within the decision-making framework for regulatory and reimbursement decisions.
Keywords: value of hope; statistical significance; patient preferences; risk attitudes value of hope; statistical significance; patient preferences; risk attitudes

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MDPI and ACS Style

Mahlich, J.; Dheban, S. Bright Line or Lottery? On Significance and Value in Medical Decision Making. J. Mark. Access Health Policy 2021, 9, 1981574. https://doi.org/10.1080/20016689.2021.1981574

AMA Style

Mahlich J, Dheban S. Bright Line or Lottery? On Significance and Value in Medical Decision Making. Journal of Market Access & Health Policy. 2021; 9(1):1981574. https://doi.org/10.1080/20016689.2021.1981574

Chicago/Turabian Style

Mahlich, Jörg, and Srirangan Dheban. 2021. "Bright Line or Lottery? On Significance and Value in Medical Decision Making" Journal of Market Access & Health Policy 9, no. 1: 1981574. https://doi.org/10.1080/20016689.2021.1981574

APA Style

Mahlich, J., & Dheban, S. (2021). Bright Line or Lottery? On Significance and Value in Medical Decision Making. Journal of Market Access & Health Policy, 9(1), 1981574. https://doi.org/10.1080/20016689.2021.1981574

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