ABSTRACT
In the previous edition of this book, we somewhat optimistically predicted that our field would advance beyond its modest beginnings and move towards more sophisticated methods and measures that would achieve realistic predictions in line with the needs of decision makers. Although there has been progress, this has been patchy, and much remains to be done. Despite increasing attention to medicine’s high costs and universal desire for prices to be “value-based”, we still don’t have a viable, methodologically sound solution. This need grows more acute as research leads to highly targeted treatments and breakthrough cures at prices far exceeding the paltry sums we have been used to. New valuation methods are tentatively coming into view, and the enormous amounts of data being collected offer tantalizing new options while posing substantial challenges, ranging from the technical to the ethical. If these can be addressed and the current gulf between regulatory approval and market access is bridged, the considerable efficiencies gained may turn out to be the most productive way to bring us to a value-based healthcare system.
