“EP152: American Style Value Frameworks with Leela Barham, Health Economist”
by Stacey Richter

Listen to the MP3 file directly by clicking here.

In an interesting contrast to Europe and NICE-style (NICE | The National Institute for Health and Care Excellence) value frameworks, in the US, value frameworks are free market, grass-roots and coming from clinicians and payers.

Today I discuss the present and future of value frameworks with Leela Barnham, a health economist based in London.

Leela Barham is a Health Economist by training with an MSc Health Economics from the University of York and BSc Economics from the University of Nottingham. Leela has over a decade of experience in consulting, working with clients from across the world.

Leela focuses on policy and health economic issues from pharmaceutical pricing to Health Technology Assessment and more. Leela has worked with patient organizations, the NHS, a health insurer, think tanks, the pharmaceutical industry, and the medical device industry and has been an expert reviewer for the Department of Health to support on issues on innovation.

Leela has also worked for the Royal College of Nursing and NERA Economic Consulting, and has been a member of the Department of Health’s External Advisory Group on Payment by Results and the HFMAs Costing Special Interest Group.

Leela’s work has been published in a number of journals and she also regularly contributes to pharmaceutical industry magazines. She has also been a peer reviewer for journals including the European Journal of Health Economics and The Patient.


00:00 What a Value Framework looks like.
02:00 Identifying the components of value.
04:00 Giving Clinicians the tools to have conversations about value.
07:00 Accepting and Understanding uncertainty.
07:50 “Here are some gaps, how can we work collectively to explore that?”
08:20 “It’s not about trying to find an average patient, it’s about saying, here’s a collection of options.”
10:00 Patient Centricity.
12:00 “How can we make sure the value framework is not a rulebook?”
14:15 The opportunity of Value Frameworks.
15:00 Consumer reports in Healthcare.
17:00 Comparative clinical effectiveness, incremental cost effectiveness, and contextual considerations in Value Frameworks.
17:45 Issues of budget impact.
19:40 “It’s not just the report that comes out, but the conversations that come out of that.”
22:20 What a Value Framework looks like at the Clinical Level.
25:00 “These are guidelines, not timelines.”
26:20 “Can we derive systems that incentivize behaviors?”
26:30 Putting Value-Based pricing alongside Value-Based contracting.
30:00 Value Frameworks in end-of-life care.
34:00 You can learn more on Leela Barham’s Facebook and her blog.

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