Expected Net Present Value of Sample Information: from burden to investment

The Expected Value of Information Framework has been proposed as a method for identifying when health care technologies should be reimbursed and when reimbursement should be withheld awaiting more evidence. The standard framework assesses the value of having additional evidence available to inform a current reimbursement decision. This can be thought of as the burden of not having the additional evidence available at the time of the decision. However, the information that decision makers need to decide whether to reimburse now or await more evidence is the value of investing in the creation of the new evidence to inform a future decision. Assessing the value requires the analysis to incorporate the costs of the research, the time it will take for the research to report and what happens to patients whilst the research is undertaken and once it has reported. In this paper we describe a development of the calculation of the expected value of sample information that assesses the value of investing in further research using (a) an only-in-research strategy; and (b) an only-with-research strategy.