Year: 2026
Type: article
Abstract: Background: Evidence-Based Medicine (EBM) has long been the standard in clinical decision-making; however, its emphasis on research evidence often neglects patients’ values and quality of life. Value-Based Medicine (VBM) emerges as an extension of EBM, integrating scientific evidence, patient preferences, and cost-effectiveness into healthcare practice. This paper discusses the role of VBM in palliative care, particularly in Indonesia, where challenges in implementation remain significant. Result: VBM combines the principles of EBM with quantifiable measures of patient values, such as Health-Related Quality of Life (HRQoL) and Quality-Adjusted Life Years (QALY), to guide treatment decisions. Its primary aim is not merely prolonging survival but ensuring optimal quality of life through interventions that are both effective and economically efficient. In palliative care, VBM helps reduce overtreatment, improve symptom management, and promote psychosocial support, while also optimizing resource allocation. In Indonesia, the adoption of VBM faces systemic barriers, including the fee-for-service reimbursement model of BPJS Kesehatan, limited coverage for community-based palliative care, fragmented health information systems, and insufficient professional training in patient-centered approaches. To address these issues, policy reforms are recommended, including transitioning to value-based reimbursement, expanding funding for home-based and community palliative services, integrating HRQoL and QALY into clinical evaluations, and enhancing medical education on VBM principles. Conclusion: the implementation of VBM in palliative care offers an opportunity to create a more humane, efficient, and sustainable healthcare system in Indonesia, prioritizing patient well-being and meaningful quality of life through the end of life.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7220674792